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Small real-world series also suggest that reduced-frequency dosing can hold a plateau

The Lancet 392, 2018

Red blood cell deficiencies can lead to anemia, which causes fatigue, general weakness, headaches, and dizziness

Transcobalamin II receptor polymorphisms are associated with increased risk for neural tube defects

Options include: Changing from one oral tablet formulation to another with different excipients Discussing sublingual preparations as an alternative (though evidence doesn't suggest superior absorption to oral tablets) For those on injections, checking the specific product's SmPC for excipient information In the UK, hydroxocobalamin injection is the licensed first-line treatment for B12 deficiency requiring parenteral therapy

Association between folate, vitamin B(6) and vitamin B(12) intake and depression in the SUN cohort study