Francesco Puppi, recent podium finisher of the Western States 100, wrote a thoughtful piece about the state of drug testing in ultras following the high profile test failure of Joyline Chepngeno in 2025
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18,26 Figure 2 Evaluation of Suspected Vitamin B12 Deficiency Treatment Vitamin B 12 deficiency can be treated with intramuscular injections of cyanocobalamin or oral vitamin B 12 therapy
Researchers see something far more complex - a system simultaneously managing nutrient absorption, barrier integrity, microbial interaction, and immune communication, all in real time, all in the same environment
The liver stores significant amounts of B12, providing a reserve that can last several months to years, depending on the individual's metabolic needs and the severity of prior deficiency
Schedule a consultation to discuss personalized protocols and comprehensive metabolic health assessment