The treatment itself takes only a few minutes and can easily be completed during a short office visit
B12 + MIC injections are generally well tolerated, but some individuals may experience mild side effects, including: If you experience persistent or severe side effects, consult your healthcare provider
Without adequate NAD+, cells lose the ability to repair DNA efficiently, regulate inflammation, and maintain the energy output needed for cognitive and physical performance
Patients should report side effects, concerns, or health changes

Dietary optimisation represents the first-line approach for maintaining adequate B12 status: Encourage consumption of B12-rich foods: meat, poultry, fish, eggs, dairy products For vegetarians and vegans, recommend fortified foods (cereals, plant-based milk alternatives) or supplementation Address any gastrointestinal symptoms that may be limiting dietary intake Supplementation strategies depend on the severity of deficiency and absorption capacity, following British Society of Haematology and BNF guidance: Oral B12 supplementation may be appropriate for mild deficiency or prevention in at-risk individuals with intact absorption, with dosing according to local protocols Intramuscular hydroxocobalamin injections are indicated for confirmed deficiency: With neurological involvement: 1 mg on alternate days until no further improvement, then 1 mg every 2 months Without neurological involvement: 1 mg three times a week for 2 weeks, then 1 mg every 3 months Patient safety advice includes: Contact your GP if you develop persistent tingling, numbness, unusual fatigue, memory problems, or mood changes Inform healthcare providers of all medications, including over-the-counter supplements Attend scheduled blood test appointments for diabetes and nutritional monitoring Do not stop prescribed medications without medical advice Report any suspected side effects to the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk or via the Yellow Card app) Healthcare professionals should adopt an individualised approach , considering the patient's complete medication profile, dietary habits, symptom burden, and laboratory findings
