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In fact, low B12 can even lead to its own kind of anemia

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Environ Health Prev Med (2009) 14(2):7187

Methotrexate-induced liver enzyme elevations often resolve with temporary withdrawal or folic acid supplementation, which mitigates hepatic toxicity without compromising efficacy (Balak et al

A conversation with your prescribing clinician and simple bloodwork can clarify whether B12 supplementation is genuinely needed or whether other adjustmentslike slightly increasing food intake or timing doses differentlywill restore your energy more effectively