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After initial repletion, a maintenance dose is given, often 1,000 mcg intramuscularly every month or every 2 to 3 months, to prevent recurrence of deficiency
B12 should be kept out of the reach of children
By blocking NNMT, it prevents the methylation reaction that depletes SAM and nicotinamide, thereby preserving both cofactors and restoring the metabolic machinery that NNMT overexpression had suppressed
