Methylation pathways become saturated, and excess methionine is converted to homocysteine, which may contribute to cardiovascular risk if B-vitamin cofactors (B6, B12, folate) aren't adequate
doi: 10.1111/j.1442-200x.2005.01998.x 71
The lower 2.0 milligram dose, called Ozempic, is approved by the FDA to treat type 2 diabetes (with a side effect of weight loss)
median UACR was 251 mg g 1 (interquartile range 100, 584)
It includes 1-5 intramuscular or subcutaneous injections of 1000 mcg crystalline cyanocobalamin daily, followed by oral doses of 1000-2000 mcg/day Parenteral administration should be reserved for those with significant neurological symptoms NICE guideline: Vitamin B 12 deficiency in over 16s: diagnosis and management: Malabsorption as the confirmed or suspected cause of vitamin B 12 deficiency: Offer replacement to people if: lifelong intramuscular vitamin B12 Autoimmune gastritis is the cause They have had a total gastrectomy They have had a complete terminal ileal resection If the person has a vitamin B 12 deficiency because of malabsorption that is not caused by autoimmune gastritis, or a total gastrectomy or complete terminal ileal resection (for example, malabsorption caused by coeliac disease, partial gastrectomy or some forms of bariatric surgery): Offer vitamin B 12 replacement and Consider intramuscular instead of

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