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For patients with proven indications for vitamin B12 supplements this represents roughly 42 a year each

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[2] For this reason, elevated serum homocysteine over 15 micromol/L and methylmalonic acid (MMA) over 0.271 micromol/L are considered better indicators of B 12 deficiency, rather than relying only on the concentration of B 12 in blood

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Maintenance doses are then tailored to keep those levels topped up, and their duration of effect is directly tied to the prescribed frequency (e.g., a shot every 12 weeks for many)