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NG239 Diagnostic tests evidence review (methylmalonic acid and homocysteine)

J Bone Miner Res

Whatever container you choose, be sure needles cannot break through the sides, bottom or top

Its best to stick to a regular schedule with B12 shots

Nevertheless, in cases of severe deficiency with neurological sequelae, we suggest that IM B12 is used in the first instance to replenish body stores with the treatment regimen, including dosage and formulation, optimised to keep the patient free of symptoms and tailored to the metabolic response of not only plasma B12 levels, but also confirmatory testing of homocysteine, methionine, and methylmalonic acid levels