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Youll need to work with your cardiologist to determine the best path forward. Another thing to keep in mind: If you have both HCM and coronary artery disease, it may not be clear whats causing your chest pain

However, the plasma concentration achieved determines how much NNMT inhibition occurs in target tissues

Some people may require longer treatment periods for ongoing recovery support

Initial response time also depends on: Severity of the B12 deficiency Frequency of injections Underlying health conditions Absorption and metabolism differences If youre getting your first B12 shot, your provider may start you on a more aggressive schedule, such as weekly injections until your levels are normalized