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It has not progressed through regulatory channels, there are no approved human uses, and no registered clinical trials exist for it
It was not until a genetically engineered strain of Pseudomonas denitrificans was used, in which eight of the genes involved in the biosynthesis of the vitamin had been overexpressed, that the complete sequence of methylation and other steps could be determined, thus fully establishing all the intermediates in the pathway
The preservative keeps it safe indefinitely. Benzyl alcohol inhibits bacterial growth
The optimal dosage and route of administration for cobalamin repletion and ongoing supplementation have been somewhat controversial because of inadequate studies establishing an optimal treatment regimen for affected individuals, and particularly for those with neurologic manifestations (198)
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