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It appears to have both local and systemic effects depending on route of administration subcutaneous injection, oral supplementation (though oral bioavailability is debated), and local injection into injured tissue have all been studied in animal models

This is most likely attributed to the inability of the constrained 13- and 14-membered macrocycles to adopt the proper transition states required for cleavage of the N-terminal peptide bond (Figure 8)

The quality of evidence varies because PRP preparation methods differ between providers, making it hard to compare studies directly

Use of vitamin B 12 in patients with elevated serum homocysteine levels and cardiovascular disease does not reduce the risk of myocardial infarction or stroke, or alter cognitive decline