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On-Label vs Off-Label and Compounded Products Vitamin B12 injections are an established medical treatment for confirmed B12 deficiency and related conditions (for example, pernicious anemia and certain malabsorption states), as summarized by the NIH Office of Dietary Supplements in its Vitamin B12 fact sheet for health professionals

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doi: 10.3390/molecules28196902 174

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Also, a small non-randomized study 15 in two older adults treated with ALC (2 g/day for 12 weeks), reported a decrease in HDRS scores from 15 to 0 and from 20 to 3 by week 12 and compared outcomes with six non-depressed controls