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However, high-dose oral therapy (10002000 micrograms daily) may be considered in specific circumstances, such as confirmed dietary deficiency in vegans without malabsorption, though this requires specialist assessment

Cover the area with a bandage if desired

In these groups of patients with risk factors who are taking metformin, especially over the long term, the new MHRA guidance suggests we should consider checking vitamin B12 levels as part of annual review bloods this is a significant change to current typical practice

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Its best to stay hydrated, avoid alcohol for 24 hours, and maintain light activity to support the bodys natural fat elimination process