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Alternatively, for patients who prefer oral treatment and have sufficient absorption, high-dose oral cyanocobalamin (1-2 mg daily) may be considered, although its effectiveness in pernicious anemia is still debated [22]

Its formulation is specifically designed to support multi-dose use while helping maintain the quality of reconstituted compounds over time

In most cases, treatment for B12 deficiency is effective, and a person will not continue to have symptoms

Its mechanisms appear to involve modulation of multiple growth factors, the nitric oxide system, and various signaling pathways associated with tissue regeneration