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A randomized controlled trial in 167 older adults (50 years) found two-year supplementation with vitamin B 12 (10 g/day), along with folic acid (200 g/day), vitamin B6 (10 mg/day), riboflavin (5 mg/day), and vitamin D (10 g/day), had no effect on bone mineral density (total hip, femoral neck, or lumbar spine) compared to the control group only receiving vitamin D (10 g/day ) (116)

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Signs That B12 Treatment Is Working Recognising the signs of treatment response helps patients and clinicians assess whether B12 therapy is effective

Being honest about that gap is not a weakness of this guide it is the accurate picture, and it is why every dosing figure here is framed as a research protocol rather than a recommendation