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The standard regimen involves: Loading doses without neurological involvement : 1 mg intramuscularly three times a week for 2 weeks [3] [8] Loading doses with neurological involvement : 1 mg intramuscularly on alternate days until no further improvement [3] [8] Maintenance therapy : 1 mg every 23 months for life in cases of pernicious anaemia or irreversible malabsorption (every 2 months if neurological involvement) [3] [8] This aggressive approach aims to prevent irreversible neurological damage, though recovery of established neuropathy may be incomplete, particularly if treatment is delayed

Good sources of vitamin B12 include: meat salmon and cod milk and other dairy products eggs For vegans, some alternatives are: yeast extract (including Marmite) fortified breakfast cereals and soy products Diet is not usually the cause of vitamin B12 deficiency in the UK - the most common one is pernicious anaemia

Also, invasive therapies are associated with adverse effects including bleeding, infection, nerve damage, and blood clots (Douketis 2016a

B12 shots can help with neuropathy and improve neurological function