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Red-flag symptoms requiring urgent assessment include new or progressive neurological symptoms (neuropathy, ataxia, cognitive change) or unexplained macrocytic anaemia

11 Intranasal Delivery Review (PubMed)Intranasal administration of Semax: the validated clinical route for nose-to-brain peptide delivery

The combination of tirzepatide and AOD9604 is being explored in some research settings, since tirzepatide (a GLP-1/GIP receptor agonist) works through different mechanisms including appetite suppression and improved insulin sensitivity

The exact timeline really depends on how severe your deficiency is and how well your body absorbs the supplement