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This decline can be accelerated by environmental toxins, high levels of stress, poor nutrition, and even intense physical overexertion

The NHS Inform Scotland guidance ties the maintenance schedule to the cause of the deficiency, which is why the plan is revisited rather than left on autopilot

Pyridoxine Dosage, Concentration, Route of Administration Dosage: Seek advice from a licensed physician, medical director, or other healthcare provider Concentration: 85mg/ml Route of Administration: IV/IM/SQ Resources: Precautions/Side Effects of Pyridoxine A number of medications may interact with pyridoxine

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It makes B12 a less likely explanation, though a borderline number alongside ongoing symptoms is still worth a second look