9 23 26 A recent Cochrane Review found that available studies only provide very low quality evidence that oral B 12 is as efficacious as intramuscular B 12 in improving symptoms
These injections are administered directly into the hip muscle for increased absorption
A deficiency can also cause a condition called megaloblastic anemia which creates larger, immature, and abnormal red blood cells and leads to impaired DNA synthesis
Similarly, folate requirements rise during active cell division, and inadequate folate can limit the effectiveness of B12 therapy
When B12 levels fall below optimal ranges, the integrity of this myelin sheath can become compromised, potentially leading to nerve damage known as peripheral neuropathy
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