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The 40 mg/mL concentration exists primarily so that researchers on the standard 10 mg or 15 mg doses can use smaller injection volumes

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Then an extra arm session

A more recent hypothesis postulates that high-dose folic acid redirects the active form of vitamin B12 in serum, i.e., holotranscobalamin, either toward the bone marrow to support reticulocyte synthesis that is induced by folic acid in B12-deficient patients, or into the urine in which it is excreted instead of being taken up and recycled into circulation through the kidneys (84)

High doses of B12 were successful in bringing the subjects sleep-wake cycles back into a normal range