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The NICE guideline recommends that doctors first use one of the primary tests for B12

Treatment of chronic postinfectious fatigue: Randomized double-blind study of two doses of sulbutiamine (400-600 mg/day) versus placebo

Total area under the curve (AUC), the standard measure of bioavailability, shows no statistically significant difference between routes in published pharmacokinetic studies

It also plays a vital role in supporting the immune system and liver function

However, dangerous levels of methemoglobinemia only occur in patients with G6PDH deficiency and, thus, this drug should not be administered to anyone with a deficiency of this enzyme

Furthermore, inactivation of these proteins leads to inhibition of both NAMPT signaling and a CSC-like phenotype