I would suggest that the l-carnitine fumarate be started first. When you get peeled off the ceiling TMG can help calm that or if that doesn't occur then the SAM-e. Start 1 thing at a time. The Dibol Dibencoplex apperars to be far more effective for AdoCbl. The Source Naturals MeCbl was an absolute zero, the worst MeCbl I ever tried. It was indistinguishable from CyCbl. The Anabol Dibencoplex caused a noticeable increase in activity over the Source Naturals.