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Heres my game plan: Test for intrinsic factor antibodies if my doctor offers this Try high-dose sublingual B12 (5000mcg daily) for 8 weeks as a test If my B12 stays below 400 pg/mL, go straight to injections Calculate the cost difference to justify the investment The 10% Rule If youre absorbing less than 10% of your oral B12 (you can estimate this by comparing your supplement dose to your blood response), weekly shots often cost less than daily high-dose pills