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Information for Patients: Patients with pernicious anemia should be informed that they will require monthly injections of vitamin B12 for the remainder of their lives

These include fortified breakfast cereals, plant-based milk alternatives (soya, almond, oat), nutritional yeast, and some meat substitutes

Clinical trials commonly start with 1 mg weekly and gradually increase the dose to higher levels such as 4 mg, 8 mg, or even 12 mg depending on the study protocol

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Skin reactions or injection site effects may occur with B12 supplementation but are not caused by elevated serum levels