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(4) Macro-B12 becomes a reasonable consideration when a value is very high, persists over time, comes with no B12 exposure, sits alongside an unrevealing workup, or disagrees with functional markers
A slow, steady injection allows the B12 solution to disperse in the tissue, leading to better absorption
It remains a research compound that some clinics and individuals have begun using despite the lack of regulatory approval
Follicles that have completely miniaturized or been replaced by scar tissue likely will not respond to any topical treatment
It is also non-invasive, which reduces the likelihood of complications typically associated with more aggressive treatments
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Comment: We received many comments related to the effective date of the proposed requirements at 180.50, with nearly all such commenters asserting that our proposed timeline was aggressive and that it would be unreasonable to require hospitals to update the data elements and implement the changes by January 1, 2026
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