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These individuals may benefit from supplementation under medical guidance, with monitoring to ensure appropriate dosing and response to treatment

This is lifelong

[18] [26] Off-label uses [edit] Restless legs syndrome [edit] Sleep medicine physicians sometimes prescribe tramadol (or other opioid medications) for refractory restless legs syndrome (RLS)

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In another study 13 of patients with known pernicious anemia who had not received maintenance vitamin B 12 injections for months to years, the rise of methylmalonic acid and homocysteine levels was found to precede the decrease in serum vitamin B 12 and the decline in hematocrit