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The COA should support documentation review, not replace independent technical judgment

Ultimately, implementation of immune-augmenting nutritional supplements within breast cancer care may require personalized approaches taking into consideration tumour subtype, underlying immunologic competency/deficiency, previous treatments received, microbiome profile and comorbid autoimmunity as well as multidisciplinary teamwork to translate promising immunobiologic signals into safe and empirically defined adjuncts to conventional anticancer immunity that are additive rather than counterproductive to patient health (197)

For individuals with low B12 levels or those who have difficulty absorbing B12, more frequent injections may be necessary to maintain optimal levels

Caffeine tolerance and detoxification capacity vary significantly by individual