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Intranasal administration is valued as a non-invasive means of both systemic and local administration with good bioavailability, rapid onset, and targeted effects on the central nervous system [13, 14]

Frost-free freezers are also not ideal because their automatic defrost cycles cause temperature fluctuations

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For individuals requiring supplementation due to confirmed deficiency or malabsorption, therapeutic doses vary considerably depending on the underlying cause: Dietary deficiency : 50150 micrograms daily orally, or cyanocobalamin tablets as prescribed Pernicious anaemia : Initially hydroxocobalamin 1 mg intramuscularly three times weekly for two weeks, then maintenance injections every two to three months [3] Neurological involvement : More intensive regimens may be required, with hydroxocobalamin injections on alternate days until symptom improvement [3] NICE guidance emphasises that supplementation should be evidence-based rather than speculative