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Chemotherapy with drugs like 5-fluorouracil has also been associated with acute thiamine deficiency by disrupting thiamine activation, so oncology patients receiving such therapy might receive parenteral thiamine supplementation as part of this B-Complex if needed

Cyanocobalamin, by contrast, requires enzymatic conversion in the liver and tissues to become active

Xu J, Moatamed F, Caldwell JS, Walker JR, Kraiem Z, Taki K, Brent GA, Hershman JM (2003) Enhanced expression of nicotinamide N -methyltransferase in human papillary thyroid carcinoma cells

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If the person appears nervous or tense, advise them to put their weight on the leg or arm that you aren't injecting to help relax the muscles

While specific therapies for IBM are still lacking, NAD + boosters have shown promising results in various models, including nematodes with amyloid aggregation, aged rodents, and human muscle cells from IBM patients