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What's the best way to overcome elevated homocysteine levels and B12 deficiency is to maximize your methylation by changing certain lifestyle choices which include smoking cessation, getting enough exercise, eating a healthy, balanced diet, and taking vitamin B12 injections

However, bioavailability is variable (so levels should be monitored when transitioning from IV to PO)

Research shows that around 50 percent to 60 percent of ingested vitamin B12 is usually absorbed when enough intrinsic factor is present in relation to B12, but absorption decreases drastically when this ratio changes

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