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This is key to quickly fix the deficiency and ease symptoms

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For patients on established B12 injection therapy, monitoring is based primarily on clinical response and haematological parameters rather than routine serum B12 measurements, which may remain very high without indicating harm or overtreatment

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Elevated homocysteine level is associated with an increased risk for atherosclerotic and thrombotic events.45 Meta-analysis of 30 studies involving 5073 ischaemic heart disease (IHD) events suggested that elevated homocysteine level was at most a modest independent predictor of IHD and stroke risk in healthy populations, and a 25% reduction in homocysteine levels was associated with 11% and 19% reduction in IHD and stroke, respectively.46 Another meta-analysis also provided a strong evidence of the causal association between homocysteine and cardiovascular disease, and showed that lowering homocysteine level by 3 mol/L could reduce the risk of IHD by 16% and stroke by 24%.47 Vitamin B 12 , folic acid, and vitamin B 6 are required for homocysteine metabolism, and often nutritional deficiency of these vitamins can cause hyperhomocysteinaemia