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As a general clinical principle: Retest HbA1c no sooner than three months after commencing B12 replacement therapy, and ideally once haematological recovery has been confirmed Confirm haematological recovery normalisation of MCV and haemoglobin before interpreting the repeat HbA1c as reliable Use interim glucose monitoring such as fasting plasma glucose, OGTT, or self-monitored blood glucose (SMBG) to assess glycaemic control during the treatment period

In relation with PD, Vit B12 is considered as a natural Leucine-Rich Repeat Kinase 2 (LRRK2) kinase inhibitor

United States Lynn Sonberg Book Associates

Drawbacks of Oral Vitamin B12 Supplements Absorption Challenges : The absorption of B12 from oral supplements can be less efficient than injections, especially in people with digestive issues

This means that higher doses may be needed