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MeCbl is an active form of vitamin B12 essential for DNA methylation, neurologic function, and prevention of homocysteine-related toxicity.1–5 Its preferential neuronal uptake and role in one-carbon metabolism support myelin integrity and genomic stability, with deficiency associated with neurologic dysfunction, including neuropathy, and oxidative stress.1–4 Parenteral MeCbl bypasses absorption barriers and has been investigated for neuropathy, neuralgia, ALS, autism, and pain, though evidence across these indications remains preliminary and investigational.2,6–9 Across the reviewed studies, MeCbl was generally well tolerated, with no drug-related serious adverse reactions identified.6–12 Because the compound is light- and oxidation-sensitive, injectable preparations require protective handling, aseptic sterile filtration, and compliance with regulatory standards for raw-material quality and sterile manufacturing