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Heres a rough guide that some doctors use, though everyones situation is different: Kidney Function and B12 Dosing Considerations: Above 90 (Normal): Standard B12 doses are usually fine, check levels every 6 months 60-89 (Mild decrease): Might consider slightly lower doses, check every 4 months 30-59 (Moderate decrease): Definitely worth discussing lower doses with your doctor, check every 3 months 15-29 (Severe decrease): High doses probably arent a good idea, monthly monitoring Below 15 (Kidney failure): Avoid high doses entirely, close medical supervision Let me share a story that really opened my eyes to this