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Cress says that a proper lab workup and discussion with a physician are necessary to discover or rule out whether inadequate B12 levels could be at play. Once discovered, treatment for a vitamin B12 deficiency can be oral, applied under the tongue, administered through the nose, or taken the form of various types of injections, according to Cress

While topical application has minimal systemic absorption, the precautionary principle suggests avoiding use during pregnancy unless a healthcare provider approves

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however, these studies frequently lack methodological rigor, appropriate controls, and adequate statistical power to confirm efficacy