A B12 deficiency can be caused by a number of different factors
If your provider identifies B12 deficiency despite your compounded formulation, they may prescribe additional B12 supplementation, either through separate injections, high-dose oral supplements (1000 mcg daily, which can overcome absorption limitations through passive diffusion), or sublingual formulations
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Martinez-Rico JC, Chavez-Alvarez S, Herz-Ruelas ME, Sosa-Colunga SA, Ocampo-Candiani J, Suro-Santos Y, Vazquez Martinez O