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Due to progressive baroreflex dysfunction and other, to date not fully understood, additional mechanisms, about 50% of individuals with neurogenic OH paradoxically develop hypertensive blood pressure (BP) levels in the supine position [59, 66] that can be severe and last for several hours during sleep (nocturnal hypertension)

In contrast, methylcobalamin is attached to a methyl group , which is a naturally occurring compound in the body and is easily utilized by the body

Adverse Reactions

Expecting visible changes in the first 1-2 weeks sets unrealistic expectations

Exclusion Criteria Inability to give informed consent or comprehend study information