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Available online at: 68 RosenbergN.MurataM.IkedaY.Opare-SemO.ZivelinA.GeffenE.et al (2002)

Recommended Timing Protocols Morning Fasted Protocol (Most Common): Timing: Upon waking, before any food or caloric beverages Fasting Window: At least 8-10 hours fasted from overnight sleep Post-Injection: Wait 30-60 minutes before eating breakfast Activity: Light fasted cardio or morning routine before first meal may enhance fat mobilization Advantages: Convenient, consistent daily routine, maximizes overnight fasted state Pre-Exercise Protocol: Timing: 30-45 minutes before fasted cardio or training session Fasting Window: At least 4-6 hours since last meal Rationale: Exercise during fasted state with elevated free fatty acids may enhance fat oxidation Considerations: Not suitable for high-intensity training

Trans-thoracic echocardiography (TTE) and CMR are used to diagnose effusion and pericardial thickening (202, 207)

Because of this, individuals supplementing this form of B12 often report improved quality of sleep, often will require slightly less sleep, and will not uncommonly report that they feel a bit more refreshed when waking in the morning

They also had a placebo group receiving dummy injections for comparison