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Vitamin B12 injections are generally safe and well tolerated, with fewer side effects than corticosteroids
Sublingual forms appear similarly effective to standard oral tablets
Methylmalonic acid (MMA) and homocysteine levels become elevated in B12 deficiency, but these tests are not routinely available in all NHS laboratories and can be confounded by renal impairment
But a better choice is combining adenosylcobalamin and hydroxocobalamin, a precursor of vitamin B12 that benefits the myelin nerve sheath and supports mitochondrial health
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