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It takes several years to completely deplete your livers stores of B12, so people who have recently started a vegan or vegetarian diet may still have moderate vitamin B12 levels.[ref] Dietary sources: Foods that are highest in B12 include:[ref] beef liver mussels lamb caviar chicken livers High Homocysteine and B12: Homocysteine levels: If your homocysteine levels are high and you carry the MTHFR or MTRR reduced function variant above, supplementing with vitamin B12, methylfolate, riboflavin, and B6 may help to lower your levels.[ref][ref][ref] Interaction with alcohol: Alcohol is metabolized into acetaldehyde, which is toxic and inhibits methionine synthase (MTR)

In further embodiments, the invention encompasses a cation of Formula IA, wherein: the cation of Formula IA includes two or more non-hydrogen substituents at positions R 2 -R 8 , and wherein: R 5 is H or NH 2 , R 6 is H or F

For these individuals a B12 energy shot is extremely beneficial and could likely be their only significant source of B12

Follow-up labs usually confirm resolution within a few months, though patients with recurring symptoms may eventually switch to methylcobalamin for its additional cellular benefits