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23 Supplementation of 1 mg daily is recommended for patients with specific risk factors (e.g., bariatric/gastric surgery patients, those with severe malnutrition, chronic alcohol use, chronic hemolytic anemia and conditions with high cell turnover, and use of antimetabolite medications such as methotrexate)

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The AAFP’s evidence-based clinical review states directly: “Oral administration of high-dose vitamin B12 (1 to 2 mg daily) is as effective as intramuscular administration for correcting anemia and neurologic symptoms in patients with B12 deficiency” (Langan RC, Goodbred AJ, American Family Physician, 2017)