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Treatment doses depend on the cause: pernicious anaemia typically requires intramuscular hydroxocobalamin 1,000 micrograms three times weekly initially, whilst dietary deficiency may be treated with oral cyanocobalamin 50150 micrograms or 1,000 micrograms daily

Disclosure of interest: Sheng-Feng Sung: This research was supported by the National Science and Technology Council [grant number NSTC 112-2221-E-705-001-MY2]

doi: 10.1016/j.hrthm.2012.01.006

People who dont eat animal products, like vegetarians and vegans, might struggle to get enough B12 through diet alone, although you can find B12 in fortified cereals and soy products

Signs of a severe allergic reaction (anaphylaxis) include: Skin rash, hives, or severe itching Swelling of the face, lips, tongue, or throat Difficulty breathing or wheezing A rapid heartbeat or a sudden drop in blood pressure If you ever develop swelling of the face or throat, trouble breathing, or other signs of a severe reaction after any injection, treat it as an emergency and call 911

Needlestick Safety and Prevention