NICE guidelines recommend hydroxocobalamin 1 mg intramuscularly three times weekly for 2 weeks (without neurological involvement) or on alternate days until no further improvement (with neurological symptoms)
Unlike oral vitamin C supplements, which face absorption limitations due to saturable sodium-dependent transporters (SVCT1), vitamin C injections deliver the nutrient directly into systemic circulation
Protocols require reconstitution with bacteriostatic water, subcutaneous or intramuscular injection, and refrigerated storage at 28C post-reconstitution
Tong Q, Tsai J, Tan G, Dalgin G, Hotamisligil GS
Many feel early changes within a couple of days, especially in energy and focus
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