In a randomized, double-blind, placebo-controlled trial in 2,919 participants (65 years) with elevated blood concentrations of homocysteine, supplementation with vitamin B 12 (500 g/day) and folic acid (400 g/day) for two years did not decrease the risk of osteoporotic fracture despite reductions in homocysteine (120, 121)
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Elevated serum B12 levels may sometimes indicate underlying medical conditions rather than true overdose, warranting clinical investigation to exclude haematological disorders, liver disease, or renal impairment
Can be combined with non-stimulant fat burners (like L-carnitine) or mild thermogenics to enhance metabolic effects
Many patients report improved skin texture, stronger nails, and healthier hair after consistent B12 injections
Hydroxocobalamin may also be given intravenously in certain scenarios (for example, 5 g IV for acute cyanide poisoning antidote therapy), but such high-dose use is in emergency settings and distinct from routine deficiency treatment
