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The amount varies depending on age, dietary intake, and medical conditions

Front Immunol 2016;7:394.ArticlePubMedPMC 51

Seek medical advice if you experience: New-onset insomnia or significant sleep disruption that persists after starting B12 supplementation Paradoxical fatigue : Worsening tiredness despite taking B12, which may indicate an underlying condition requiring investigation Neurological symptoms : Tingling, numbness, balance problems, or cognitive changes, which could suggest B12 deficiency or other neurological conditions Mood changes : Anxiety, agitation, or depression that develops or worsens after starting supplementation Palpitations or rapid heartbeat : Though rare, some individuals report cardiovascular symptoms that should be evaluated It's important to note that sleep disturbances may be unrelated to B12 supplementation

This lower dosing option was recently introduced to help reduce gastrointestinal side effects while maintaining efficacy and enabling smoother escalation than the original dosing strategy