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Most people get enough vitamin B12 from eating a balanced diet

Recharging aged-CAR with NAD(+) to boost immunotherapy

In a long-term randomized, double-blind, placebo-controlled study among sufferers of cerebrovascular accidents at high risk of depression, daily supplementation with 2 mg of folic acid, 25 mg of vitamin B6, and 500 g vitamin B 12 significantly lowered the risk of major depressive episodes during a seven-year follow-up period compared to placebo (111)

Intramuscular therapy leads to more rapid improvement and should be considered in patients with severe deficiency or severe neurologic symptoms

However, if medications lose their effectiveness over time or cause significant side effects, surgical treatment may be considered