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Because of this, I recommend any patient who is symptomatic and has suboptimal levels of vitamin B12 (as defined above) consider a trial of sublingual B12

Vitamin B12 injections are commonly used by: Individuals with long-term fatigue Vegetarians and vegans Older adults People with digestive conditions Patients taking certain medications A pharmacist-led consultation helps determine whether B12 injections are suitable based on symptoms and medical history

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However, these antibodies do not appear to impact efficacy or cause significant allergic reactions, suggesting they are neutralizing rather than pathogenic