The right starting point is always understanding why your levels are low, whether supplementation is needed, and what form of B12 is most suitable
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Patients who have had their band removed or adjusted, or who have experienced significant weight regain, may have altered nutritional needs and should seek reassessment from their bariatric team
It is important to distinguish between excessive supplementation and pathologically elevated B12 levels, which may indicate underlying haematological disorders, liver disease, or renal impairment rather than true overdose
IGF-1 signaling is mitogenic and anti-apoptotic both relevant to cancer biology
This difference should be factored into the decision-making process