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The patient lacks intrinsic factor, a protein mandatory for the intestinal uptake of a physiological dose of B12

It may prove useful in some individuals but it remains an extrapolated and nuanced position, not yet one settled with robust evidence

The fourth option is exemplified by the use of the streptococcal endopeptidase imflimidase, which cleaves the HC of all four subclasses of IgG and the IgG-like B cell receptor on CD19 + memory B cells [410,411,412], thereby depleting the IgG pool and possibly lowering the production of IgG [410, 413]

For 2 mg dose: 2 / 1 x 100 = 200 units (full vial) 5 mg vial + 2.5 mL water = 2 mg/mL