By Lauren Opatrny, PT, DPT, PHRC San Francisco, CA Ischial bursitis, or ischiogluteal bursitis, is a condition where the bursa that lies between the ischial tuberosity and the gluteus maximus muscle becomes inflamed.(1) Ischial tuberosities are the bones that we sit on and are commonly referred to as your sits bones. They provide support for the body while sitting and serve as an attachment site for several muscles and tendons
Why Are B12 Injections Used Instead of Tablets
Factors That Affect the Timeline Baseline NNMT Activity High NNMT (faster results): Obesity or metabolic syndrome Insulin resistance History of yo-yo dieting Poor energy levels Low NNMT (slower results): Already lean and metabolically healthy Good baseline energy levels Regular exercise routine Dosing Consistency Optimal Timeline: Daily dosing without missed days Appropriate dose for body weight and goals Consistent timing (morning preferred) Delayed Timeline: Inconsistent dosing Starting with too low a dose Taking with large meals (may reduce absorption) Supporting Factors Accelerated Results: Clean diet with adequate protein Regular resistance training Good sleep quality (7+ hours) Stress management Hindered Results: High-stress lifestyle Poor sleep quality Excessive alcohol consumption Underlying thyroid issues By Use Case: Specialized Timelines For Weight Loss (Primary Goal) Weeks 1-4: Focus on energy improvements, not scale Weeks 6-12: Primary fat loss phase Weeks 12+: Maintenance and metabolic optimization For Metabolic Health (Insulin Resistance) Weeks 2-4: Energy improvements Weeks 4-8: Insulin sensitivity improvements (bloodwork) Weeks 8-16: Full metabolic restoration For Energy/Performance Weeks 1-2: Initial improvements Weeks 2-6: Significant enhancement Weeks 6+: Optimized and stable energy When to Adjust the Protocol Signs It's Working: Improved energy within 2-3 weeks Better exercise performance Gradual weight loss starting weeks 6-8 Improved bloodwork markers Signs to Reassess: No energy improvements by week 4 No weight changes by week 10 (if weight loss is the goal) Persistent side effects Energy levels decreasing after initial improvement Adjustment options described by community sources: Increasing the dose (if below research range) Adjusting timing (morning vs evening) Addressing supporting factors (sleep, stress, diet) Using bloodwork to assess NNMT inhibition Realistic Expectations by Timeline The figures below reflect self-reported community timelines, not controlled trial outcomes
He also recommends increasing exercise, especially using the large muscles in arms and legs
While experiences can vary, side effects are rare and typically mild, such as slight soreness at the injection site, or a temporary flushed feeling
