Delayed Treatment: Vitamin B12 deficiency left untreated for longer than 3 months may cause permanent spinal cord and nerve damage
A randomized controlled trial in 167 older adults (50 years) found two-year supplementation with vitamin B 12 (10 g/day), along with folic acid (200 g/day), vitamin B6 (10 mg/day), riboflavin (5 mg/day), and vitamin D (10 g/day), had no effect on bone mineral density (total hip, femoral neck, or lumbar spine) compared to the control group only receiving vitamin D (10 g/day ) (116)
Hydroxocobalamin 1mg is the standard UK formulation, typically administered every two to three months for maintenance therapy Self-administration requires GP prescription, competency training from practice nurses, and demonstration of proper injection technique Common injection sites include the thigh (vastus lateralis) for both intramuscular and subcutaneous administration with site rotation essential Serious side effects are rare but anaphylaxis requires immediate 999 call
To stay motivated, establish quantifiable short-term targets, employ follow-up, and monitor non-scale victories such as reductions in waist size and increased fitness
