I feel that the medical personnel will start to apply the current science if and only if their confidence/arrogance in they know best is shaken. How, when or if that will happen I have no idea.
I can predict the future, just not with any accuracy. 😀
This is the trend that I think the treatment may be going. (Not only not a medic I do not have the ability to be one.)
IM injections may be replaced by SC injections. Injections may start at 1mg EOD and be increased if the patient feels they are relieved when they have their next injection. Upper limit may be they no longer experience improvement with an increase.
The understanding of co-factors may advance as the amount of B12 is increased and the body utilizes/uses up more co-factors due to the increase.
The biologists and chemists will continue to improve the science and the medical personal will still misapply it. They may discover sublingual to be as effective as SC or IM injections. Not oral.
The reversing out will likely still happen, the understanding may change in that the severity of reversing out will be seen to be reduced with increased B12 injections. That the current dosage recommended in some cases will cause the body to have enough B12 to heal somewhat which causes symptoms to be worse than they might be and last longer than may be necessary.
New chemical forms of cobalamin may be synthesized and it may be found that there is one form for every body or one of the existing forms may be found to be effective with the advancing knowledge of co-factors.
B12 deficiency may be treated prior to any mental health diagnosis being made as is currently done in the USA regarding thyroid issues.
Testing may improve and no longer be used to misdiagnose. Note: B12 testing is not the only test that sucks, by a long shot.
Physicians will still preach the healthy life style and continue to not have a higher life expediency.
Pharmaceutical companies and insurance companies will thrive.
It is also possible that although not toxic to much B12 may be detrimental to healing as the neurological system heals too fast. This might also lead to emotional issues caused by the neurological system being able to handle some issues in a way they could not be processed before treatment.
Or something else entirely