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192 Another trial included 83 men with at least one abnormal sperm parameter who received either 2 grams of combined L-carnitine and acetyl-L-carnitine plus 250 mg L-arginine, 100 mg glutathione, 40 mg CoQ10, 7.5 mg zinc, 234 mcg folic acid, 2 mcg vitamin B12, and 50 mcg selenium or placebo daily for six months

Tier 3: Oral Capsules and Sublingual Formulations Lower Evidence Basis Oral BPC-157 in capsule form has a plausible local GI mechanism (supported by animal studies showing mucosal effects)

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Diagnosis of deficiency Diagnosis of vitamin B12 deficiency is mainly based on laboratory blood tests