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Many clinics schedule weekly IM visits for several weeks and reassess based on logs (nutrition, physical activity, sleep) and patient feedback
Its inclusion does not substantially increase manufacturing costs or retail pricing
While B12 is generally safe, caution is needed in specific clinical situations: Lebers Disease (Hereditary Optic Neuropathy): B12 injections are generally contraindicated or should be used with extreme caution, as they may potentially aggravate optic atrophy in this rare condition
In pernicious anemia, holotranscobalamin decreases whereas in dietary deficiency, holotranscobalamin will remain relatively stable while total serum B12 decreases
Nature , 508(7495), 258262
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