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As a rule of thumb, start low, use consistently, and only escalate if a lower concentration is well tolerated and you have a specific reason to

The redox-sensitive transcription factor NF-E2 related factor-2 (Nrf2) suppresses brain endothelial cell monocyte adhesion via upregulation of the redox-related mitochondrial transporter ABCB10 [24]

Monitoring recommendations: Baseline investigations: Full blood count, B12 level, folate, and intrinsic factor antibodies (if pernicious anaemia suspected) During initial treatment: Potassium monitoring in severe deficiency (risk of hypokalaemia) Follow-up: Repeat full blood count after 8 weeks to confirm haematological response Long-term: Annual review to ensure compliance with maintenance injections

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