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Am J Surg 2018;216:760-3

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higher-dose oral therapy (1,000–2,000 micrograms daily) may be considered as an alternative to injections in selected cases with adequate absorption For those taking supplements , consider these safety principles: Use supplements only when clinically indicated (confirmed deficiency or high-risk groups such as vegans, elderly, or those with malabsorption) In the UK, hydroxocobalamin is the preferred injectable form Avoid mega-doses without medical supervision