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doi: 10.2478/s11756-019-00337-5 98
For patients who experience a paradoxical decrease in energy levels, it doesnt mean you should stop taking the B12 but instead decrease your dose by half (so take 2,500mcg every 7 days) or simply take 5,000mcg every 14 days instead
Slowing the ramp to the label cadence (2.5 mg start, 2.5 mg steps, four-week holds) dropped that to mid-single digits at every maintenance dose, at no cost to the 12-week result, and the dedicated slow-titration trial reached placebo range. Reaching 15 mg is not the problem
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