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As we age, B-12 absorption can pose challenges, compounded by factors such as weight loss surgery or procedures involving stomach reduction

Dosing does not typically require gender-based adjustment, though individual response should always guide protocol modifications

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[2] During a monotherapy clinical trial of topiramate in the treatment of epilepsy in adults, hypertonia was reported in 0% of patients receiving 50 mg/day and 3% of patients receiving 400 mg/day

These include the competing effects of the formation of cobalamin-like molecules in our body (the so-called cobalamin analogues or pseudo-cobalamins), which may impair the proper action of the good cobalamin