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According to the Mayo Clinic, your doctor may recommend: Shots of vitamin B12 (monthly or more often, if needed) Vitamin B12 supplements, in pill form or as a nasal spray Treatment of underlying conditions, such as Crohns disease, celiac disease, or alcoholism Dietary changes Justin Laube, MD Medical Reviewer Justin Laube, MD, is a dual board-certified integrative and internal medicine physician, retreat leader, and healing educator with over 15 years of experience caring for patients w