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Initial Treatment Dosages for Severe Deficiency Adults with severe vitamin B12 deficiency often start with higher doses

Additional research suggests that NNMT inhibition may influence lipid signaling

Andersson, Emmanuel Shapira, Biochemical and clinical response to hydroxocobalamin versus cyanocobalamin treatment in patients with methylmalonic acidemia and homocystinuria (cblC), The Journal of Pediatrics, Volume 132, Issue 1, January 1998, Pages 121-124, ISSN 0022-3476, Okuda K, Yashima K, Kitazaki T, Takara I

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Folic acid status should be evaluated before starting B12 therapy