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Other relevant interactions: Colchicine (used for gout) may affect B12 absorption with long-term use Chloramphenicol (rarely used antibiotic) may blunt the haematological response to B12 treatment Monitoring considerations: Patients taking loop or thiazide diuretics require careful monitoring when initiating B12 therapy in severe deficiency, due to the risk of hypokalaemia during rapid cell production

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[2] Heffernan, M., Summers, R

The selective mechanism that avoids systemic hormonal disruption suggests potential for extended use compared to interventions that create metabolic or endocrine imbalances requiring periodic breaks