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If a compounded product is genuinely the only option, both Stanford clinicians advised verifying it comes from a registered outsourcing facility rather than an unregistered online seller and staying under close medical supervision
For adults under age 65, the easiest way to get B12 is to take at least one 2,000 mcg supplement each week or a daily dose of 50 mcg
Refrigeration is required: store the vial at 2-8C (36-46F)
For those with neurological symptoms, hydroxocobalamin 1 mg is given on alternate days until no further improvement is observed, as recommended by NICE guidance and the product information
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