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According to the NICE Clinical Knowledge Summary (CKS) and the British National Formulary (BNF) , the standard treatment for B12 deficiency without neurological symptoms involves: Hydroxocobalamin 1 mg intramuscularly three times weekly for two weeks Followed by maintenance doses of 1 mg every three months For patients with neurological symptoms (such as paraesthesia, numbness, cognitive changes, or gait disturbances), more intensive treatment is required: Hydroxocobalamin 1 mg intramuscularly on alternate days until no further improvement occurs Followed by 1 mg every two months for maintenance Pernicious anaemia , an autoimmune condition where the body cannot produce intrinsic factor, requires lifelong treatment

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For example, additives such as carboxymethyl cellulose and mannitol can cause acute reactions

How long does the B12 shot last

Many clinics provide training for patients to self-inject at home, especially for long-term therapy