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According to the NICE Clinical Knowledge Summary (CKS) and the British National Formulary (BNF) , the standard treatment for B12 deficiency without neurological symptoms involves: Hydroxocobalamin 1 mg intramuscularly three times weekly for two weeks Followed by maintenance doses of 1 mg every three months For patients with neurological symptoms (such as paraesthesia, numbness, cognitive changes, or gait disturbances), more intensive treatment is required: Hydroxocobalamin 1 mg intramuscularly on alternate days until no further improvement occurs Followed by 1 mg every two months for maintenance Pernicious anaemia , an autoimmune condition where the body cannot produce intrinsic factor, requires lifelong treatment

1g) (compared with Gipr AP-GFP mice), RER, energy expenditure or ambulatory activity, as measured in metabolic cages (Extended Data Fig

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three randomized clinical trials Each of these studies shows that in terms of increasing serum vitamin B oral vitamin B 12 is just as effective as IM B 12 12 levels