It includes 1-5 intramuscular or subcutaneous injections of 1000 mcg crystalline cyanocobalamin daily, followed by oral doses of 1000-2000 mcg/day Parenteral administration should be reserved for those with significant neurological symptoms NICE guideline: Vitamin B 12 deficiency in over 16s: diagnosis and management: Malabsorption as the confirmed or suspected cause of vitamin B 12 deficiency: Offer replacement to people if: lifelong intramuscular vitamin B12 Autoimmune gastritis is the cause They have had a total gastrectomy They have had a complete terminal ileal resection If the person has a vitamin B 12 deficiency because of malabsorption that is not caused by autoimmune gastritis, or a total gastrectomy or complete terminal ileal resection (for example, malabsorption caused by coeliac disease, partial gastrectomy or some forms of bariatric surgery): Offer vitamin B 12 replacement and Consider intramuscular instead of
High doses can stress the kidneys, especially in those with pre-existing conditions
Interestingly, pork-based products have significantly lower vitamin B12 content (and iodine), around one-third less, compared with the early 1990s (Niklewicz et al., 2023)
5-Amino-1MQ is a small-molecule quinolinium compound that has been the focus of metabolic and enzymatic research, particularly in relation to its potential role in inhibiting nicotinamide N-methyltransferase (NNMT), an enzyme implicated in metabolic regulation and obesity-related studies
This is the form I use with my patients in the injections
