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TIMP-1 and TIMP-3 modulate this degradation

Because the body cannot make B12 on its own, it has to come from food (meat, fish, eggs, dairy) or from supplements

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Even when enforcement seems inconsistent: Professional discipline is still possible Licenses can still be challenged Liability does not disappear because something is popular This is why many clinics: Avoid written prescriptions Avoid dispensing directly Use vague educational language Distance themselves from sourcing Those behaviors are signals of regulatory uncertainty not proof of legality

Leading medical sources, including The BMJ and Harvards Nutrition Source, emphasize that elevated B12 levels alone do not indicate toxicity or adverse effects

This means the injection must be administered in an outpatient setting and associated with a qualifying diagnosis