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I think that you will find most successful PA patients treat their symptoms - they take enough often enough to see the symptoms recede and can then balance it from there

doi: 10.1038/nature25743 153 ZhaoQ.ZhouH.LiX.XiaoB

Assays of biochemical materials related to hepatocyte injury and lipid metabolism in the model of steatosis hepatocyte The above periodic subcultural LO2 and HepG2 cells were respectively seeded into 24-well plates in sextuplicate at a starting density of 510 4 cells/well in 500l medium and cultured for 48h

Specific clinical scenarios where injections are the standard of care include pernicious anemia, severe malabsorption syndromes, post-bariatric surgery when oral supplementation has failed, and critically low serum B12 levels accompanied by neurological deterioration

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