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The most chemically complex of all the vitamins, methylcobalamin is a water-soluble, organometallic compound with a trivalent cobalt ion bound inside a corrin ring which, although similar to the porphyrin ring found in heme, chlorophyll, and cytochrome, has two of the pyrrole rings directly bonded

The perception of B12 shots as 'energy boosters' largely stems from the dramatic improvement seen when treating genuine deficiency, where fatigue is a cardinal symptom

Verbalis, J

Patients on anticoagulants, those with active infections, or those with Polycythemia vera should seek provider clearance

When a patient with any type of diabetes mellitus has documented neuropathy and both conditions are listed in the medical record, coders must assign the diabetic neuropathy combination code (E08.4xE13.4x) even if the provider does not explicitly state due to diabetes. The provider need not use the exact phrase due to diabetes

Long-term low B12 can drive elevated homocysteine and contribute to megaloblastic or pernicious anemia