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For oral cobalamin supplementation: Protocol: Daily administration for a total of 12 weeks and re-check the serum cobalamin concentration 4 weeks after stopping supplementation
At maintenance doses of 1.7-2.4mg, published protocols consume roughly one 5mg vial every 2-3 weeks
limiting alcohol enhances treatment outcomes
Dosing tiers: Nasal administration provides rapid CNS penetration via the olfactory mucosa
Hair shedding several months into rapid loss is usually telogen effluvium, the temporary response seen after many large weight changes rather than direct drug toxicity
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