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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

There are oral products and injectable forms, and the route may affect where it acts most

Of course, I provide the scientific substantiation for the protocols that are included

Despite its announcement to the stock exchange in 2007 that trials showed at 24 weeks participants lost one kilogram at best, only last month Metabolic told its patent holders that it was going ahead with attempting to license the product in the US for use in sports drinks and dietary supplements

Remember, accurate diagnosis starts with understanding the language of anemia