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This is because healthy levels of B12 can lower homocysteine

Improper dosing or timing can lead to diminished results or unwanted side effects like hypoglycemia

While its safety profile was consistently favorable, the largest Phase IIb trial failed to show statistical significance for weight loss, and commercial development was halted in 2007.[2] Despite this, interest in AOD-9604 has continued in the compounding pharmacy and integrative medicine space, particularly given its safety data, its lack of IGF-1 stimulation, and emerging research around joint health

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While it's not approved by the FDA for general medical use, it can be accessed legally under specific conditions