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One of the things they found was when B12 serum levels drop below 550 pg/mL, cerebrospinal fluid levels of vitamin B12 become low

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For those with hypermobility and EDS specifically, Id flag the following as the minimum due diligence before starting these medications: A thorough GI history and ideally gastric emptying assessment if theres any existing dysmotility Baseline muscle mass measurement (DEXA or similar) given the sarcopenia risk A clear plan for high-protein diet and resistance-based exercise to mitigate muscle loss Baseline bone density if theres any existing concern Consideration of the nutritional picture specific to hypermobility, since these drugs can affect appetite and nutrient absorption A conversation specifically about MCAS if thats a feature of your presentation The medication options for hypermobility and EDS are limited and often unsatisfying, and its entirely understandable why people are looking at something new with genuine curiosity