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Official Recommendation: Fasting NOT required for serum B12 testing Most labs do not require fasting Guidelines do not mandate fasting However, Some Experts Suggest: Overnight fast preferred for consistency Avoid B12 supplements for 24-48 hours before the test Avoid excessive B12-rich foods the day before the test Why the Controversy

This may vary from twice weekly to once every 2-4 weeks (source: The basics of treatment It is not understood why certain patients require more frequent B12 treatment