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You should also contact your GP if: You are unable to attend scheduled maintenance injections, as missing doses can lead to symptom recurrence You develop new symptoms that might indicate other deficiencies or health problems You are planning pregnancy, as B12 requirements may change You experience persistent side effects such as headaches, dizziness, or gastrointestinal symptoms If you experience any side effects, talk to your doctor, pharmacist or nurse
Most practitioners recommend starting at 250-300 mcg daily to assess tolerance, then potentially increasing to 400-500 mcg if initial response is suboptimal and no side effects occur
Other factors include: Underlying cause of deficiency : Pernicious anaemia, malabsorption disorders, or dietary insufficiency may affect treatment response Medication use : Metformin and proton pump inhibitors can reduce gastrointestinal B12 absorption (though this does not affect the efficacy of intramuscular injections) Individual variation : Differences in how efficiently your body utilises the injected vitamin Adherence to treatment schedule : Missing injections or delaying maintenance doses can slow recovery Discussing these factors with your healthcare provider helps set realistic expectations for your treatment journey
This is a formidable, often moving-target objective
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