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While it is known that B-vitamin supplementation effectively treats hyperhomocysteinemia, there is a need for well-designed, large trials to evaluate the effect of B-vitamin supplementation on long-term outcomes, such as age-related cognitive decline and the incidence of Alzheimers disease

For really bad cases, you might need more, and shots are given once a week, or as the doctor says

It supplies the mechanistic and directional rationale for the whole compound class, but it is not a human trial and does not establish a human dose

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[DOI] [PubMed] [Google Scholar] 45.Reich K, Leonardi C, Lebwohl M, et al