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For confirmed B12 deficiency without neurological involvement , the standard regimen comprises 1 mg hydroxocobalamin intramuscularly three times weekly for two weeks, followed by maintenance doses every two to three months for those with irreversible causes like pernicious anaemia

Some also notice their digestion shifting a bit as their body adjusts

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The framing is that adding a second agent adds a tolerability cost as well as a benefit, which is part of what a provider weighs before recommending both together