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Results Inhibition of mitochondrial fat oxidation in skeletal muscle prevents a local inflammatory response in Cpt1b m/ mice Cpt1b m/ mice have elevated plasma lipids, and accumulation of both intramyocellular lipid (IMCL) and lipotoxic species such as DAG and ceramides, but they have lower fasting insulin and glucose, improved glucose tolerance, and no impairment of insulin signalling in skeletal muscle 23

Dosing information Usual Adult Dose for Pernicious Anemia: Initial dose: 100 mcg intramuscularly or deep subcutaneous once a day for 6 to 7 days If clinical improvement and reticulocyte response is seen from the above dosing: 100 mcg every other day for 7 doses, then: 100 mcg every 3 to 4 days for 2 to 3 weeks, then: Maintenance dose: 100 to 1000 mcg monthly Duration of therapy: Life Comments: Administer concomitant folic acid if needed

Mood Changes: Research has linked low vitamin D levels to mood disorders, including depression and anxiety