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Without treatment, this can be fatal

Patient Counseling Information Instructions Patients should be informed of the potential risks and benefits of Janumet and of alternative modes of therapy

Skin benefits : Reduces fine lines and wrinkles Improves skin thickness Enhances firmness and elasticity Evens skin tone Reduces hyperpigmentation Promotes healing of scars and damage Improves texture Mechanisms : Stimulates collagen I and III production Promotes elastin synthesis Enhances hyaluronic acid Improves blood flow to skin Antioxidant protection Protocol : Topical : Apply serum/cream 2x daily Injectable : 1-2mg daily subcutaneous Expected results : Visible improvement in 8-12 weeks, significant changes by 6 months

Importantly, neurological symptoms such as tingling, numbness, or unusual sensations are more commonly associated with B12 deficiency rather than excess