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Once the 28-day refrigerated-use window is included, that works out to three 80 mg vials at the low 1.6 mg dose, three at the standard 3.2 mg dose, or four at the elevated 4.8 mg dose

This is typically performed under local anaesthesia

Transdermal forms of vitamin B 12 are available over the counter, but this route of administration has not been validated clinically in the setting of vitamin B 12 deficiency and should not be relied upon for treatment

Future research should focus on refining these treatment modalities and expanding comparative studies to optimize B12 deficiency management strategies effectively

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Some research from Germany has shown that an even higher threshold (over 500 pg/mL) is necessary in early-to-mid pregnancy to maintain vitamin B12 levels throughout pregnancy, lactation, and to support an infants vitamin B12 status (via breast milk) through 6 months of age