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In a diabetes MRI substudy, liver fat fell up to 47% at 15 mg versus about 11% on insulin. In biopsy-confirmed fatty-liver disease with fibrosis, a large share of participants on 15 mg had disease resolution versus a small share on placebo. These are not microdose data

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There are other reasons why someone may react to L-5MTHF, and hydroxocobalamin does not address all of them

Mood improvement: B12 plays a role in producing neurotransmitters that regulate mood, so correcting a deficiency can help alleviate feelings of depression or anxiety that you might not have realized were connected to your B12 status