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B12 shots are particularly effective for deficiency management when: A healthcare provider has confirmed serum B12 levels below 200 pg/mL

Yu T, Wang YT, Chen P, Li YH, Chen YX, Zeng H, Yu AM, Huang M, Bi HC (2015) Effects of nicotinamide N -methyltransferase on PANC-1 cells proliferation, metastatic potential and survival under metabolic stress

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Other vegetarian sources of B12 include shitake mushrooms, edible seaweeds especially green and purple laver

For individuals requiring supplementation due to confirmed deficiency or malabsorption, therapeutic doses vary considerably depending on the underlying cause: Dietary deficiency : 50150 micrograms daily orally, or cyanocobalamin tablets as prescribed Pernicious anaemia : Initially hydroxocobalamin 1 mg intramuscularly three times weekly for two weeks, then maintenance injections every two to three months [3] Neurological involvement : More intensive regimens may be required, with hydroxocobalamin injections on alternate days until symptom improvement [3] NICE guidance emphasises that supplementation should be evidence-based rather than speculative

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