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When B12 levels are low, restoring them through diet and supplementation can improve energy, but it usually takes consistent intake over several weeks

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Gupta, P., & Kumar, S

Dosing typically begins at a lower dose, suggested initiation of 4 units (0.04 mL) weekly for the first 4 weeks, then escalates according to a titration schedule: Weeks 1-4: Inject 4 units (0.04 mL) one time per week Weeks 5-8: Inject 8 units (0.08 mL) one time per week Weeks 9-12: Inject 18 units (0.18 mL) one time per week Weeks 13-16: Inject 30 units (0.3 mL) one time per week Week 16+: Inject 44 units (0.44 mL) one time per week Dosing may deviate from this pattern to accommodate patient-specific needs

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The median changes in total vitamin B12 and holotranscobalamin (holoTC) concentrations over time