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Things that might lead to dose changes include how bad the deficiency was, if there are nerve symptoms, if theres ongoing trouble absorbing nutrients, and how each patient responds

For humans, self-production of B12 through the intestinal bacteria is theoretically possible, but rarely achieved for health reasons, which is why humans today depend on a dietary intake of B12 in almost all cases

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doi:10.1016/j.tox.2011.03.001, PMID: 21414382 Valko M, Morris H, Cronin MT (2005) Metals, toxicity and oxidative stress