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For most patients with vitamin B12 deficiency, high-dose oral supplements are as effective as intramuscular injections at raising serum B12 levels and resolving symptoms

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Timing is also a useful clue

and levothyroxine, requiring separation by 4 hours) [9] [10] Any decision to combine these medications should be made collaboratively between patient and prescriber, with careful consideration of individual circumstances, treatment goals, previous responses to monotherapy, and the patient's ability to tolerate potential side effects