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Generally well tolerated, with injection-site reactions the most common adverse event
For people with no neurological involvement Initially administer hydroxocobalamin 1 mg intramuscularly three times a week for 2 weeks, then administer hydroxocobalamin 1 mg intramuscularly every 23 months for life
(2020) Comparison of sublingual and intramuscular administration of vitamin B12 for the treatment of vitamin B12 deficiency in children
Your doctor may: Monitor serum B12 levels Evaluate homocysteine and methylmalonic acid (MMA) Check complete blood count (CBC) Assess for symptom improvement (fatigue, cognitive clarity, neuropathy) Symptoms like improved energy, mood, and focus typically appear within days to weeks
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