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Epub 2018 Mar 15

IV therapy delivers a larger volume of fluid into a vein through a catheter over a longer session

Children presenting neurological signs or symptoms, those unable to take oral medication, individuals with known malabsorption syndromes, infants under 6 months old, and patients using medications that may interfere with vitamin B12 absorption are typically treated with a parenteral protocol (1)

There is no good evidence for a B12 'detox' or 'toxin release', so treat that framing with caution

The 2024 NICE guideline NG239 sets out a more intensive loading schedule for patients with neurological involvement precisely because their starting point is worse