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The popular claim that the effect fades after 4 to 6 weeks so you have to cycle is a widely repeated myth with no primary study behind it, and the mechanism actually argues against a classic tolerance effect

Oral supplements can be recommended for some dogs or an injection of cyanocobalamin (usually 1,000 mcg/mL) may be recommended for dogs with severe deficiencies or poor intestinal absorption

Comment: A few commenters asked for CMS to add HCPCS code Q2056 (Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose) to this list of Cell and Gene Therapies excluded from C-APC packaging for CY 2026