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Of particular note, the researchers reported that lower levels of CD320 or dietary B 12 restriction worsened the disease course in an animal model of MS and reduced the therapeutic efficacy of fingolimod, which occurred through a mechanism in which fingolimod hitchhikes by binding to the TCN2-B12 complex, allowing delivery of all to the astrocytes via interactions with CD320, with component losses disrupting the process and worsening disease

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If IV access isn't feasible, use NAC at 1800mg daily combined with oral milk thistle (silymarin) at 300600mg daily

Li M, Zhong D, Li G

Since B12 helps with energy levels, patients are more motivated to continue their diets and exercise, more than those who are not receiving B12 injections