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[7] [8] Prescription and administration: Once B12 deficiency is confirmed, GPs prescribe hydroxocobalamin injections according to standardised protocols: Standard loading regimen: 1mg intramuscularly three times weekly for two weeks Neurological involvement: 1mg intramuscularly on alternate days until no further improvement Maintenance therapy: 1mg every three months for life in pernicious anaemia or malabsorption conditions (or every two months if there was neurological involvement) Injections are typically administered by practice nurses at GP surgeries

However, transitioning between medications should be done carefully and under medical supervision to monitor for side effects and determine the most appropriate dosage

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The findings highlight a critical gap in current management strategies that rely solely on hormonal normalization, underscoring the need for more comprehensive care that addresses underlying metabolic dysfunction

What people typically notice across the ladder Timeframe Week 12 (2.5 mg) What is reported Mild appetite reduction