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The people who run into trouble are those who started closer to the lower end of normal, around 200-300 pg/mL, where even a modest decline pushes them into deficiency

In regards to supplementation, the NHS advises that taking 2mg or less a day of Vitamin B12 in supplements is unlikely to cause any harm

For those dealing with nerve issues like numbness or tingling, B12 injections can help ease those discomforts

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And the difference between "fixing a real deficiency" and "megadosing when you're already fine" is the difference between a genuine improvement and expensive urine

By the time visible skin concerns appear, your cellular reserves are already significantly depleted