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Do not shake vials vigorously

The 0.25 mg dose works as a taper floor or cautious restart, but it is not tested long-term maintenance

Clinical laboratories generally define vitamin B12 deficiency as a serum level below 148 pmol/L (approximately 200 pg/mL)

People with Certain Medications: Long-term use of medications like proton pump inhibitors or metformin can interfere with B12 absorption, leading to a deficiency

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