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Two decades later, Kovalzon and Strekalova (2006) [6] were equally direct, calling DSIP a still unresolved riddle and noting that the connection between the peptide and sleep has never been further characterized, in part because of the lack of isolation of the DSIP gene, protein and possible related receptor. That framing has not materially changed in the literature since

Vitamin B12 may reduce the effectiveness of some chemotherapy drugs, such as methotrexate or 5-fluorouracil, and may also be impacted by medications like metformin, proton pump inhibitors (PPIs), and certain antibiotics (e.g., chloramphenicol)

According to her rheumatologist

The strongest signals keep clustering around skin, healing, hair, inflammation, and broader anti-aging support