Oral B12 (50150 g daily) may be appropriate for dietary deficiency without neurological involvement, but intramuscular hydroxocobalamin injections remain first-line treatment in the UK for patients with nerve symptoms or malabsorption conditions
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This varies by state, but there is always a Paramedic or Registered Nurse (RN) on staff at all times
The report of Olesen et al
The timing, severity, and accompanying symptoms can provide valuable clues about whether the supplement is genuinely responsible or whether another cause should be investigated
Some patients may require injections more frequently, and if a true deficiency is identified, several injections over 1-2 weeks are needed, known as a loading dose
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