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They are not regulated under FDA drug manufacturing standards

The possibility that sustained folic acid intake would deplete vitamin B-12 independent of hematopoiesis suggests a plausible alternative mechanism based on the known details of the renal handling of holoTC, whereby folic acid might interfere with holoTC reuptake or cause its sequestration in the kidney, promoting the excretion of holoTC and further depleting metabolically active vitamin B-12 during vitamin B-12 deficiency
B12 deficiency can cause anxiety, depression, panic, and stress

References & Peer-Reviewed Sources Translational Andrology and Urology The Journal of Sexual Medicine National Institutes of Health (NIH) American Urological Association (AUA) Sexual Medicine Reviews

provide extended service support for reusable injection devices, covering defects for up to 18 months post-delivery
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