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The NHS treatment pathway splits B12 injections into two phases, a loading phase to top you up quickly, then a maintenance phase to keep you there

Oral contraceptives can decrease the action of Mecobalamin by reducing its concentration in the body

Gut health testing is beneficial because B12 absorption occurs in the small intestine, and conditions that affect gut functionsuch as bacterial overgrowth, malabsorption disorders, or inflammatory diseasescan lead to B12 deficiency, ter Keurs says

Medication remains effective unless storage conditions are poor or it has expired rather than due to the body building tolerance