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Suggested starting points to discuss with your clinician Deficiency without malabsorption: 1,0002,000 mcg oral cyanocobalamin daily until normalized, then weekly or monthly maintenance per labs (AAFP)
It also slows stomach emptying, which reduces hunger and calorie intake
Regular sessions focused on nutrition that matches your changed appetite, strength training to protect muscle and building habits that will support you whether you stay on the medication or come off it
This creates a clinical dilemma during pregnancy and preconception care, as safety data have historically been limited due to the systematic exclusion of pregnant women from randomized controlled trials
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