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It can reverse damage already done, at least in rats

Treating Pernicious Anaemia Injections are the preferred method of treating Pernicious Anaemia Lifelong intramuscular vitamin B12 replacement for people if autoimmune gastritis/Pernicious Anaemia is the cause, or suspected cause, of vitamin B12 deficiency

The downstream effects most consistently described in the literature: induction of collagen I and III, elastin, and decorin synthesis (Maquart et al., FEBS Letters , 1988), upregulation of VEGF and basic FGF transcripts, induction of antioxidant defense genes including SOD2 and metallothionein isoforms, and modulation of the MMP-2 and TIMP-1/2 balance toward non-fibrotic remodeling

"Sterility Assurance in Pharmaceutical Manufacturing: Current Practices and Future Trends." PDA Journal of Pharmaceutical Science and Technology, 77(3), 301-315

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Dosing for back pain: Loading phase protocols typically involve 2-2.5mg twice weekly for four to six weeks