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NICE guidance recommends intramuscular hydroxocobalamin as first-line treatment for B12 deficiency caused by pernicious anaemia or malabsorption

Pregnant or breastfeeding women should consult their doctor or health care practitioner

High-risk patient factors include active gastrointestinal symptoms (odds ratio 7.66, 95% confidence interval 3.4217.17), early treatment phase (less than 4 weeks), higher medication doses, pre-existing diabetic gastroparesis, obesity (BMI greater than 30), and gastroesophageal reflux disease [31]

The actual process is surprisingly peaceful

Research suggests it may have potential for tissue development and compositional changes