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The presence of comorbidities can significantly impact the pharmacokinetics of Vitamin B12, making it essential to adjust dosing protocols. Expert Opinion on Vitamin B12 Therapy Genetic Factors Affecting B12 Metabolism Genetics play a role in how well someone can use Vitamin B12

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The AAFP advises that injectable therapy leads to more rapid improvement and should be considered in patients with severe deficiency or severe neurologic symptoms (Langan RC, Goodbred AJ, 2017)