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Early initiation of folic acid supplementation (210 mg/kg/day) is recommended, and patients who begin supplementation before the age of 6 years tend to have a better prognosis than those who start supplementation after the age of 6 years [101]

Specifically, individuals carrying the CC genotype at this locus were identified as the susceptible population

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Over time, the circuit reasserts itself, hunger signals return at lower body weights than they would have appeared at without medication, and the patient finds that maintaining the deficit takes more deliberate effort than it did in months one through six

Importantly, serum B12 levels can be misleadingly normal or even elevated in chronic liver disease due to increased levels of binding proteins (such as haptocorrin) and reduced clearance, meaning that total B12 measurements may not accurately reflect tissue B12 status or functional deficiency