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We also see many individuals who follow strict vegetarian or vegan diets, which can increase the risk of B12 deficiency due to limited intake of animal-derived foods

A reasonable titration schedule might look like this: Week 1: 200mcg once daily Week 2: 300mcg once daily Week 3 onward: 300-500mcg based on response and tolerance Optimizing injection technique Poor injection technique contributes to injection site reactions and potentially to other effects like nausea from anxiety around the process

It also avoids the pain and cost of repeated clinic visits