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While a balanced diet or oral supplements are often sufficient for maintaining adequate B12 levels, certain conditions may necessitate vitamin B12 injections

Extreme deficits (800-1,000 calories below maintenance) are unnecessary and counterproductive because they increase muscle catabolism and metabolic adaptation
The first hypothesized mechanism is via the stimulation and secretion of the VEGF, leading to the growth of blood vessels in the area surrounding the hair follicles

Interaction with fasting and ketosis Both fasting and ketogenic diets increase NAD+ levels through various mechanisms
