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So, if you are eating a varied diet and do not have a laboratory-documented vitamin B12 deficiency, you do not need additional supplementation. However, she explains people who subscribe to strict vegan or vegetarian diets are much more likely to be at risk of vitamin B12 deficiency, and they should take supplemental B12, especially when pregnant or trying to become pregnant
Journal of Clinical Medicine, 7 (10), 304
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Yes, for some individuals, a combined approach of B12 injections and tablets, or transitioning from injections to high-dose oral supplements for maintenance, is a viable and effective strategy
The role of homocysteine in increasing the risk of hemolysis in vitamin B12 and folate deficiency has been demonstrated in vitro .[7] We postulate that the high homocysteine levels in our case may have played a role in ensuing hemolysis in addition to intramedullary destruction of RBCs
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