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For deficiency without neurological involvement or for borderline levels, oral supplementation with high-dose cyanocobalamin (1000-2000 mcg daily) is often effective, as approximately 1% of an oral dose is absorbed through passive diffusion even in the absence of intrinsic factor

The maximum dose of 3 mg achieves optimal weight loss but is reached through a dose titration starting from 0.6 mg subcutaneously once daily, increased weekly

Visceral fat reduction typically becomes measurable between 26 months, with maximal effects achieved at 6068 weeks

Start with a low dose and increase gradually to avoid temporary worsening of bloating