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Use aseptic technique, rotate sites to prevent soreness, and use an appropriate needle (e.g
5000mcg methylcobalamin per capsule Active coenzyme form | Directly usable without conversion
I'm not medically trained but if someone has symptoms consistent with B12 deficiency and the symptoms improve/disappear with B12 injections/B12 supplements then it would suggest to me that the person needed B12
And then I would point out that there seems to be something else going on regardless of the amount of B12 in the patients blood
