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doi: 10.1111/J.1365-2125.2011.03991.X 59 GunnJ
Elevated methylmalonic acid or homocysteine with normal-ish b12 suggests functional deficiency requiring supplementation
Research protocols typically use daily dosing for 714 days during the induction phase, with therapeutic effects lasting 30+ days post-treatment despite complete plasma clearance within 12 hours of the final dose
Age-related factors include reduced gastric acid production (achlorhydria) in older adults, which impairs B12 liberation from food
Stress Protection Normalizes blood pressure, modulates corticotropin, inhibits somatostatin
