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becomes particularly relevant, and the answer truly varies depending on a few key factors: The Underlying Cause of Deficiency: The Underlying Cause of Deficiency: Pernicious Anaemia/Malabsorption: For those with an inability to absorb B12 orally (like in pernicious anaemia), injections are typically a lifelong treatment

it can be a signal that one of them is present

In short, I have to supplement with methylated B12 because my body is missing the enzyme to turn B12 into the cellularly available form of methylfolate