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The 2024 NICE Guideline NG239 from the United Kingdoms National Institute for Health and Care Excellence similarly distinguishes between patients who can be managed with oral therapy and those who require intramuscular treatment
"Clinical Vitamin B12 Deficiency
Key considerations for oral formulations: Convenient: Familiar to most patients and easily integrated into daily routines without clinic visits
This is because they have trouble absorbing B12 from food
Drawing a 7.5mg dose At 5mg/ml (2ml water added): You need 150 units
Patients with diagnosed diabetes should monitor glucose closely, as MOTS-cs insulin-sensitizing effects may potentiate hypoglycemia when combined with antidiabetic medications
