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Additionally, it is now known that pro-inflammatory cytokines also hijack IGF-1 intracellular signalling by phosphorylating serine residues on insulin related substrate (IRS) molecules and hence impeding their binding to IGF-1R [124]

If you suspect deficiency, your primary care doctor can order bloodwork and identify the underlying cause

The only effective therapy is supplementing thiamine

The benzyl alcohol in bacteriostatic water also suppresses bacterial growth, which is what allows the reconstituted vial to last 28 days in the fridge instead of 24 hours

Here is what the evidence actually supports

I will recommend a schedule tailored to your needs during your consultation