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Furthermore, the authors reported a notably higher incidence of transient adverse effects such as injection site pain, dizziness, and leg numbness in the prolotherapy group

13-15 Although the precise molecular mechanisms underlying methylcobalamin-mediated myelination are unknown, a number of models have been suggested, including increased synthesis of lecithin (the primary component of myelin sheath lipids) 16,17

Sarzi-Puttini P, Giorgi V, Atzeni F, Roberto G, Kosek E, Choy E, Bazzichi L, Huser W, Ablin J, Aloush V, Buskila D, Amital H, Da Silva J, Perrot S, Morlion B, Polati E, Schweiger V, Coaccioli S, Varrassi G, Batticciotto A

In one ED-focused study, inadequate B12 levels were reported in some participants, and deficiency can cause symptoms like fatigue, nerve issues, and mood changes that may indirectly undermine sexual performance