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For many individuals, diet and oral supplementation are sufficient

What if conservative management is not working

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These include: Age and overall health status Severity of Vitamin B12 deficiency Presence of underlying medical conditions, such as gastrointestinal disorders Concurrent medications that may interact with Vitamin B12 For example, older adults or those with severe deficiencies might need more

High expression of CD38 in immune cells can affect their functions, such as in macrophages, regulatory T cells (Tregs), regulatory B cells (Bregs), myeloid-derived suppressor cells (MDSCs) and CD16 - CD56 + natural killer (NK) cells ( + level
