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Your provider may recommend different options based on your symptoms, goals, health history, and any relevant lab information

For patients without neurological involvement , hydroxocobalamin 1 mg is administered intramuscularly three times a week for 2 weeks, followed by maintenance injections every three months for life (if due to pernicious anaemia or other non-dietary cause)

[103] Metformin [edit] Reduced serum levels of vitamin B 12 occur in up to 30% of people taking long-term anti-diabetic metformin

In addition to this, many people have problems metabolizing B12 in low-quality forms like cyanocobalamin due to defects in the MTHFR gene (1) (as many as 40% of people have THIS problem!)