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What makes this mechanism notable is its specificity

p-AKT (phosphorylated AKT): Plays a role in cell survival, growth, and metabolism

They keep using something that's clearly not working, hoping it will eventually improve

Cofactor for L-methylmalonyl-coenzyme A mutase 5-Deoxyadenosylcobalamin is required by the enzyme that catalyzes the conversion of L-methylmalonyl-coenzyme A to succinyl-coenzyme A (succinyl-CoA), which then enters the citric acid cycle ( Figure 2 )

For anyone reconstituting peptides, hormones, or other lyophilized compounds that require dosing across multiple days, that difference isnt a minor convenience