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Patients with Leber's hereditary optic neuropathy should avoid cyanocobalamin (hydroxocobalamin is preferred in the UK)

They can also help regulate hormone levels, especially by lowering androgens (male hormones like testosterone), which tend to be high in people with PCOS

If batch preparation is necessary for large studies, use low-retention syringes and refrigerate filled syringes at 28C, using them within 12 hours to minimize peptide loss

The FDA still has specific criteria a substance must meet to be eligible for compounding, and the Pharmacy Compounding Advisory Committees July 2026 review will determine whether any of these peptides will be officially cleared