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This minimum requirement becomes the de facto standard
In this context, recognition of SAGE-DM may have practical implications by encouraging clinicians to consider alternative therapeutic priorities, including preservation of muscle mass, avoidance of overtreatment, correction of hormonal and nutritional imbalances, and individualized metabolic targets

Cyanocobalamin is indicated for vitamin B12 deficiencies due to malabsorption which may be associated with the following conditions: Addisonian (pernicious) anemia Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacteria overgrowth, total or partial gastrectomy Fish tapeworm infestation Malignancy of pancreas or bowel Folic acid deficiency It may be possible to treat the underlying disease by surgical correction of anatomic lesions leading to small bowel bacterial overgrowth, expulsion of fish tapeworm, discontinuation of drugs leading to vitamin malabsorption (see PRECAUTIONS-Drug Interactions), use of a gluten-free diet in nontropical sprue, or administration of antibiotics in tropical sprue
The right option depends on the patients symptoms, goals, safety needs, and provider recommendation