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NICE notes that pernicious anaemia is the most common cause of Vitamin B12 deficiency in those aged 40-70, with an average onset age of 60 in white people and 50 in black people, although it can affect black women at a younger age

It can, however, be injected at a "deep subcutaneous" level, which is essentially the border between cutaneous and muscular

Practically, this means that blocks performed for surgical anesthesia can be included in the anesthesia time of a case as long as a gap did not occur in the anesthesia providers continuous care

Maintain a healthy lifestyle: Engaging in regular exercise, reducing stress, and avoiding smoking and excessive alcohol consumption can all help support optimal B12 levels and enhance the effectiveness of B12 injections

Needle Selection A 23 to 25 gauge needle at 25mm suits most adult deltoids