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GPs can prescribe B12 injections following appropriate investigation, which should include: Full blood count to identify macrocytic anaemia Serum B12 and folate levels to confirm deficiency (using laboratory-specific reference ranges) Methylmalonic acid and/or homocysteine when B12 results are borderline Intrinsic factor antibodies if pernicious anaemia is suspected Additional tests depending on clinical presentation (e.g., thyroid function, coeliac serology) When both B12 and folate deficiency are present, B12 should be replaced before folate to avoid precipitating subacute combined degeneration of the spinal cord

The tradeoff versus injection is bioavailability

Before starting B12 injections, its important to consult with a healthcare provider to ensure that B12 deficiency is the underlying cause of your fatigue and to determine the right dosage for your needs

They have been used for decades and are considered an integral part of the nonsurgical management of sciatica and lower back pain