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Reticulocytosis (increased production of immature red blood cells) typically begins by day 3-4 of starting treatment, indicating active bone marrow recovery

However, generally excreted does not mean entirely without consequence. Emerging research has raised questions about whether chronically elevated serum B12 levels may serve as a marker for underlying conditions or could be associated with certain health concerns

For example, a study published in the American Journal of Clinical Nutrition found that B12 supplements reduced homocysteine levels and improved heart health in older adults

Precautions General Precautions: Vitamin B12 deficiency that is allowed to progress for longer than 3 months may produce permanent degenerative lesions of the spinal cord