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But I also back this up with other tests that look at how your body utilises B12 to check you have enough

Beyond Month 6: Maintenance Most patients continue at 2.4 milligrams weekly through month 12, when full clinical trial endpoints are typically reached

Titration: how to ramp Weeks 12: start at 0.51 mL, 12 per week

Without enough B12, red blood cells can become large and irregular (megaloblastic anemia), which reduces their ability to carry oxygen efficiently