Most patients start with every-other-night application for the first 1 to 2 weeks to minimize irritation from tretinoin, then increase to nightly use as tolerated
For musculoskeletal indications, most patients at our Doral clinic report a noticeable reduction in pain within 2 to 3 weeks and a functional improvement (range of motion, strength, load tolerance) by weeks 4 to 8
Patients in trials typically begin to notice appetite suppression and early weight loss within the first few weeks of treatment
In summary, B12 IV dosing needs a personalized approach
These adjustments should follow standard escalation timing rather than impulsive changes
While safety monitoring was comprehensive, the trials were not specifically designed to detect rare adverse effects that might occur at rates lower than 1-2%, which would require much larger participant numbers