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What this implies: if the vial remains sealed, in a cool, dry, dark place (ideally under refrigeration or freezing, with minimal humidity), you can reasonably expect 2-3 years of viability in the lyophilized state
Intramuscular (IM) B12 injections using hydroxocobalamin, the preferred licensed form in the UK are recommended when: Oral supplementation has failed to correct a documented deficiency The patient has difficulty adhering to daily oral regimens Serum B12 levels remain persistently low despite adequate oral dosing There is clinical evidence of neurological or haematological complications In line with BNF guidance, the standard IM regimen for confirmed deficiency without neurological involvement is a loading course of 1 mg hydroxocobalamin on alternate days for two weeks , followed by maintenance of 1 mg every three months
It fails because they evaluate it too soon
The B12 injection itself is quick and virtually painless, typically administered in the upper arm or hip area
