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Unexpectedly high B12 levels without supplementation warrant GP review as they may indicate underlying liver disease, kidney disease, or blood disorders

Starting Doses Most protocols recommend starting with lower doses and gradually increasing

always replace the cap or stopper promptly after withdrawing a dose

The chronic use of any of these medications has the potential to cause complications related to vitamin B12 deficiency, which includes impaired DNA synthesis, impaired cell division, hematopoiesis, hyperhomocysteinemia, and metabolism of odd-chain fatty acids that is necessary in preventing demyelination of nerves

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