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The NHS gives hydroxocobalamin as an intramuscular injection, but published evidence shows the subcutaneous route is a recognised and similarly effective alternative
What are the considerations for intravenous Vitamin B12 administration
Hydroxocobalamin plays a crucial role in the treatment of cyanide poisoning, which can occur due to smoke inhalation or ingestion of certain chemicals
No , B12 usually has the opposite effect
Other groups who may benefit include: Patients following gastric surgery (gastrectomy, bariatric procedures) where intrinsic factor production or absorption sites are compromised Individuals with malabsorption disorders such as Crohn's disease, coeliac disease, or chronic pancreatitis Strict vegans and vegetarians with dietary insufficiency, though oral supplementation is usually tried first Elderly patients with atrophic gastritis or reduced gastric acid production Patients on long-term metformin or proton pump inhibitors, which can impair B12 absorption [6] [8] Individuals with nitrous oxide exposure (recreational or medical), which can cause functional B12 deficiency Diagnosis typically involves serum B12 measurement, with levels below approximately 148 pmol/L (though thresholds vary between laboratories) generally indicating deficiency
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