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The gene encoding for leptin is mutated in genetically obese (ob/ob) mice

Methylcobalamin injections are administered by licensed clinicians using medical grade protocols and are generally well tolerated

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Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease

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However, no controlled human trial has compared oral versus injectable AOD-9604 at equivalent systemic doses