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The AAFPs 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)

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According to some scientific studies, a combination of vitamin B12 and folic acid supplementation and sun exposure is a good strategy to regain natural skin color

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As their baseline improves, some choose to transition into less frequent appointments