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Adequate planning is required for patients of reproductive age
Some studies suggest that it may modulate nitric oxide pathways and early growth response genes, which could play a role in the early stages of collagen organization
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When to increase dose Consider increasing if: Minimal response after 4-6 weeks at current dose No side effects at current dose Current dose below the higher end of recommended range Goals not being met with conservative approach Increase gradually, typically by 25-50% at a time
The British Obesity and Metabolic Surgery Society (BOMSS) recommend the following as an interim measure: For people who have had bariatric procedures (see opening paragraph) which affect vitamin B12 absorption: IMPORTANT NOTE NICE Clinical Knowledge summary: Anaemia - vitamin B12 and folate deficiency
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