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Whilst B12 injections have clear therapeutic roles supported by NICE guidance, lipotropic formulations remain controversial, unregulated, and unsupported by high-quality research

Cellular magnesium status is unknown whilst magnesium levels within acceptable range however if magnesium levels are low then typically indicates significant cellular depletion and intervention recommended

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therefore, randomized controlled trials incorporating sham or intra-articular control groups and quantitative volumetric MRI assessment of BMLs are required to confirm efficacy and define optimal patient selection

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