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a 2024 meta-analysis reported that sublingual and oral B12 supplementation appear to be as effective as intramuscular injections in improving B12 status.21 Further high-quality randomised controlled trials are required to confirm dosing strategies and long-term outcomes
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For patients with severe symptoms, treatment starts with 1000 mcg injected intramuscularly once daily for 7 days, then the frequency can vary to 1-3 times weekly for 4-8 weeks
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