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Never discontinue B12 injections without medical advice, even if you feel completely well, as deficiency can recur and cause irreversible neurological damage if left untreated
It has been found that long-term exposure to monthly fipronil treatments has selected for resistant flea strains (22), and resistant Dirofilaria immitis strains that cause heartworm disease have emerged (23)
The increase in your B12 levels will also be fairly slow, meaning that it isnt a great option for those patients who need to see them boosted fairly quickly
Abrupt cessation wont cause withdrawal symptoms or rebound effects, but metabolic markers will gradually return to baseline over 24 weeks as AMPK activity normalizes and NNMT inhibition wears off
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