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Several drugs, including colchicine, have been reported to reduce the absorption of methylcobalamin, vitamin B12

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It should be noted that these studies measured total Cbl levels, but as previously mentioned, the biologically available form of Cbl, TCN2-Cbl, comprises only approximately 2030% of the total Cbl level, which may lead to a significant number of false negatives for clb deficiency

The 8 to 12 week on / 4 to 8 week off pattern is extrapolated from pharmacological principles and community experience, not from controlled trials

As a result, oral supplementation may not be sufficient and injections may be necessary

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