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Patients on Specific Medications: Certain medications, like proton pump inhibitors or metformin, can interfere with B12 absorption, making monitoring and supplementation necessary

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Some protocols split the daily dose into two administrations (morning and evening) to maintain more consistent plasma levels, though definitive human PK data remain sparse as of 2026

Low vitamin B12 levels can cause issues such as fatigue, anemia, and lack of focus

However, this side effect is not common and can be minimized by consulting with your physician on prescribing right injection dose