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Patients with significant injury, post-surgical recovery or chronic inflammation may extend the loading phase to 8 to 12 weeks under physician supervision

doi:10.1016/j.watres.2012.07.042 Lam MW, Young CJ, Mabury SA (2005) Aqueous photochemical reaction kinetics and transformations of fluoxetine

A referral might be the most efficient path forward

Other factors include: Underlying cause of deficiency : Pernicious anaemia, malabsorption disorders, or dietary insufficiency may affect treatment response Medication use : Metformin and proton pump inhibitors can reduce gastrointestinal B12 absorption (though this does not affect the efficacy of intramuscular injections) Individual variation : Differences in how efficiently your body utilises the injected vitamin Adherence to treatment schedule : Missing injections or delaying maintenance doses can slow recovery Discussing these factors with your healthcare provider helps set realistic expectations for your treatment journey

This lipid modification allows binding to albumin in the bloodstream