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There are also under the tongue and intranasal methods that can be used once B12 levels are normalized

Nevertheless, as the disease progresses, due to a lack of neuroprotective drugs, there remains a great unmet need for effective neuroprotective or disease-modifying therapies 11

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We also analysed the effects of concomitant administration of L-carnitine and EPA

18 Table 4 Time to Improvement of Abnormalities in Vitamin B12 Deficiency After Initiation of Treatment A 2005 Cochrane review involving 108 patients with vitamin B 12 deficiency found that high-dose oral replacement (1 mg to 2 mg per day) was as effective as parenteral administration for correcting anemia and neurologic symptoms