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44 Additionally, in patients who are already taking some form of oral B 12 supplementation, demonstrating B 12 deficiency can be a challenge, even when symptoms are typical (including those of neuropathy-like paraesthesia and numbness) as serum B 12 concentrations may be just within, or sometimes above, the normal range

In the body, IGF-1 can activate growth a multitude of bodily tissues, including the nerves, bone, kidneys, and liver

While supplements are usually given as tablets, your doctor may recommend B12 injections, depending on your situation

In individuals with symptomatic B 12 deficiency despite normal dietary B 12 intake, B 12 malabsorption is the most likely cause and should guide parenteral therapy

Split dosing becomes valuable when single dosing produces inconsistent results, when doses above 400mcg are needed, or when evening administration fits better into lifestyle patterns