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Storage condition during shipping matters as well

As a traditional concept, the mild metabolic abnormalities without clinical signs or symptoms are called subclinical cobalamin deficiency (SCCD), and it may progress to clinical symptomatic deficiency or remit completely without any signs

The same applies if your elevated B12 is accompanied by abnormal results on other labs (liver enzymes, kidney markers, CBC), or by symptoms like unexplained weight loss, persistent fatigue, abdominal pain, or easy bruising

Typically, you'll receive injections containing 1000-2500 mcg of B12 combined with lipotropic compounds like methionine, inositol, and choline

Nothing I've read or the neurologist I saw read has convinced me oral b12 works as well for most people with PA or another absorbtion problem