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Statements not reaching consensus in Round 1 were rephrased in Round 2, based on free-text responses received and SC input

the titration is part of the design, not an afterthought

Over-the-counter B12 supplements are widely available in the UK in various forms, including: Cyanocobalamin tablets the most common form in supplements Methylcobalamin sometimes marketed as more bioavailable, though evidence for superiority over standard oral tablets is limited Sublingual (under-the-tongue) preparations no proven advantage over standard oral tablets has been established Combination B-vitamin complexes Patients should be aware that most supplements are regulated as food products , not medicines, and quality can vary between brands