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They complement one another and are perfectly safe when taken together

Treatment plans should be guided by a qualified provider

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Ethical approval was obtained from the relevant institutional review boards at participating sites, and all patients provided written informed consent in accordance with local requirements

This includes confirmed low serum vitamin B12 levels, pernicious anaemia, malabsorption states such as coeliac disease, inflammatory bowel disease, or post-gastric or bariatric surgery, unexplained anaemia, neuropathy or neurological symptoms consistent with vitamin B12 deficiency, a long-term vegan diet with symptoms or low levels, or failure of oral vitamin B12 supplementation