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Initial blood work is recommended to confirm whether a patient is genuinely deficient in B12 and needs supplementation, or whether another underlying issue may be affecting energy, weight, or metabolic function

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However, the minimum cutoff level is still too low at 200 pg/mL

The GDS-15 was completed by 34 patients (17 per group), with median scores initially at 2.0 in the loading dose group and 3.5 in the no loading dose group, which adjusted to 2.5 and 2.0 respectively after 90 days

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Whilst the little evidence we have supports no great risk, clinical trial and longer term data is lacking