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The absence of validated efficacy data means youre titrating based on subjective experience and hope, not on a known dose-response curve
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doi: 10.1186/s12929-018-0462-0

So, we recommend using SL vitamin B12 rather than oral and IM, especially in patients who do not tolerate IM injection and patients who need prolonged vitamin B12 supplementation, such as patients with long-term metformin use and patients with pernicious anemia or with gastro-duodenal resection [5154]