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So if you took B12 and felt worse, and your blood B12 is elevated, and you have a constellation of symptoms across multiple systems that's three signals pointing toward MCAS as worth ruling out

Elan Goldwaser, a sports medicine physician and assistant professor of medicine at the Columbia University Vagelos College of Physicians and Surgeons

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Weakness or imbalance creates impingement, abnormal tendon loading, and continued tissue damage

Important caveat: the claim that combining the three produces synergistic repair is a marketing hypothesis it has never been tested in a human trial, and no clinical data validate the specific 70 mg three-peptide combination