It takes about 2-4 weeks to begin to observe improvements
In my own clinical practice, I already recommend a full blood count as part of annual review, to ensure that the person is not anaemic and, thus, that the HbA 1c is reliable, but this also proves useful to assess MCV in this context
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Many people end up taking medications to help them feel better when all they really need is to optimize their nutrition
The vial should be kept out of reach of children, as with any medication
But people who avoid animal products can get an adequate supply through fortified breakfast cereals and nutritional yeast