Probably many factors are involved, some directly due to the drug and some to indirect or secondary effects (See Table 4)
Surgery is typically recommended in patients with full-thickness tendon ruptures, patients who are very active, and those who have failed non-operative treatment
You are paying for a completely different regulatory framework
In fact, there was a 2022 case report presented a 22-year-old student who exhibited hyperpigmentation as the only symptom of B12 deficiency
Biochemically, the cobalt center can take part in both two-electron and one-electron reductive processes to access the "reduced" (B 12r , +2 oxidation state) and "super-reduced" (B 12s , +1 oxidation state) forms
Both are water-soluble, meaning your body does not store them in large amounts