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This evidence supports the off-label use of botulinum toxin as a novel therapeutic strategy for KOA management in orthopedic practice (107)

DM = diabetes mellitus

Methylcobalamin B12 is also indicated in those with pernicious anemia, diabetes, neuropathy, heart disease, circadian rhythm sleep disorders, memory loss, depression, fatigue, AIDS, inflammatory bowel disease (IBD), Lyme disease, osteoporosis, tendonitis, psychiatric disorders, Alzheimers disease, liver and kidney disease, and asthma

10.1111/j.1440-1819.1996.tb00573.x 54

Thus, the nutrient-microbe-host meta-organismal framework linking diet and microbial metabolism to fibrosis represents a targetable pathway for therapeutics, and it will be interesting to see if selectively inhibiting microbial TMA lyase translates to a decreased propensity of fibrosis