According to the NICE Clinical Knowledge Summary (CKS) and the British National Formulary (BNF) , the standard treatment for B12 deficiency without neurological symptoms involves: Hydroxocobalamin 1 mg intramuscularly three times weekly for two weeks Followed by maintenance doses of 1 mg every three months For patients with neurological symptoms (such as paraesthesia, numbness, cognitive changes, or gait disturbances), more intensive treatment is required: Hydroxocobalamin 1 mg intramuscularly on alternate days until no further improvement occurs Followed by 1 mg every two months for maintenance Pernicious anaemia , an autoimmune condition where the body cannot produce intrinsic factor, requires lifelong treatment
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Sahraei SS, Davoodi Asl F, Kalhor N et al
10.1074/jbc.M112.415992 69 CrabtreeM
Revision History (Full details and data files) Version 1.0: 2024-08-07 Type: Initial release Version 1.1: 2025-07-02 Changes: Data collection, Structure summary
