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[1] After applying standard inclusion criteria, 36 studies remained

Combining both: Alternate ginger and peppermint

Cyanocobalamin is the man-made version of B-12

Typical daily dose: 6001000 mcg total (300500 mcg of each peptide)

Concentrations above 3 mg/mL exceed solubility limits and cause peptide precipitation, while concentrations below 0.5 mg/mL require larger administration volumes that exceed the nasal cavity's absorption capacity (approximately 150 L per nostril)

The form, dose, and timing are worth recording, and further workup becomes necessary if the elevation persists once those sources are accounted for, or if symptoms, examination findings, or other labs raise concern