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Minimizing Methylmalonic Acid Levels A potential problem with the IOMs method for determining B12 requirements (see Institute of Medicines Recommendations above), is that a small percentage of people with neurological symptoms of B12 deficiency have normal blood parameters, including 13% of patients in one series of case studies (Lindenbaum, 1988)

Here is how the process typically works at our clinic

This often stems from factors such as a perceived unpleasant taste, smell, or associated anxiety

Some practitioners implement cycling approaches (such as 12 weeks on, 4-8 weeks off), though no published research directly compares continuous versus cycled protocols

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