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This dependence on intrinsic factor is why conditions that affect the stomach including autoimmune gastritis, gastric surgery, and chronic use of proton pump inhibitors can lead to B12 deficiency even when dietary intake appears adequate

Biweekly protocols (2x per week) are sometimes used during the first 46 weeks of aggressive caloric restriction or in patients with confirmed methylation pathway deficiencies, but there is no clinical evidence that more frequent dosing produces proportionally greater fat loss

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It also means that switching between compounding pharmacies can feel like a dose change even when the labeled amount stays the same

After centrifugation (15 min, 12,000 g, 4 C), the upper aqueous phase was carefully collected and transferred into a new tube containing 1 ml of freshly prepared 70% ethanol solution, mixed by pipetting, and loaded onto a RNeasy spin column (RNeasy mini kit, Qiagen)

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