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The British National Formulary (BNF), for example, differentiates the prescription of hydroxocobalamin according to presenting symptoms, eg, “For neurological involvement, it is advised to administer hydroxocobalamin by intramuscular injection, initially 1 mg once daily on alternate days until no further improvement, then 1 mg every 2 months.” In the Netherlands, pharmacotherapeutic guidelines 51 recommend (for the same neurological symptoms or abnormalities) administration of 1000 mcg once or twice weekly for up to two years

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Take-home message: - Peptides and assorted experimental drugs, like TB-500 and MK-677, are being recommended by fitness influencers to grow bigger muscles, lose fat, and recover from injuries faster - These drugs, many of which are claimed to boost levels of growth hormone, were studied in rodents and very small groups of human volunteers before being abandoned for not being beneficial or for causing unacceptable side effects - They are banned by the World Anti-Doping Agency and appear to be illegal in Canada and the United States, but can be purchased online