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How Much Oral B12 for Pernicious Anemia For those who prefer or need oral vitamin B12, high doses are needed because of the lack of intrinsic factor
A 12-week randomized trial demonstrated: Average weight loss of 2.6 kg in AOD-9604 group (1 mg/day) versus 0.8 kg in placebo group Preferential reduction in abdominal and visceral fat deposits No adverse effects on carbohydrate metabolism or insulin sensitivity Non-dose-dependent effects, with higher doses (10 mg/day) producing less weight loss than lower doses However, a subsequent 24-week Phase III trial with 502 subjects incorporating intensive diet and exercise showed no statistically significant weight loss compared to placebo, leading to development termination in 2007

A physician investigating unexplained hypercobalaminemia will typically order some combination of the following: Complete blood count (CBC) with differential to check for abnormal red blood cell, white blood cell, or platelet counts Liver function tests (ALT, AST, ALP, bilirubin, albumin) to assess liver health Kidney function tests (creatinine, BUN, estimated GFR) to evaluate renal clearance Peripheral blood smear if a myeloproliferative disorder is suspected Abdominal imaging (ultrasound or CT) if liver or abdominal pathology is a concern Cancer-specific markers or screenings if clinical suspicion warrants them The NIH Office of Dietary Supplements fact sheet notes that observational data from a Danish registry analysis of 757,185 people found the adjusted 1-year cancer risk was 1.74 to 4.72 times higher among those with B12 above 813 pg/mL compared to those in the normal range of 203 to 813 pg/mL
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