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For confirmed B12 deficiency without neurological involvement , the standard regimen comprises 1 mg hydroxocobalamin intramuscularly three times weekly for two weeks, followed by maintenance doses every two to three months for those with irreversible causes like pernicious anaemia

This medicine may cause a rare but serious blood condition called methemoglobinemia

One study reported that vitamin B12 deficiency was associated with twice the risk of severe depression (4)

It may sound simple to decide the right treatment strategy, but the big question is how to identify patients able to absorb vitamin B12 provided by food or a vitamin pill, as compared to those who have lost the capacity to absorb vitamin B12