Tough or dense protein sources are particularly poorly tolerated, and many patients naturally gravitate towards softer, more processed foods that tend to be lower in essential micronutrients
Instead, they signal your pituitary gland (a small gland at the base of your brain) to release more of what it already produces
Intramuscular (IM) B12 injections using hydroxocobalamin, the preferred licensed form in the UK are recommended when: Oral supplementation has failed to correct a documented deficiency The patient has difficulty adhering to daily oral regimens Serum B12 levels remain persistently low despite adequate oral dosing There is clinical evidence of neurological or haematological complications In line with BNF guidance, the standard IM regimen for confirmed deficiency without neurological involvement is a loading course of 1 mg hydroxocobalamin on alternate days for two weeks , followed by maintenance of 1 mg every three months
This state may be secondary to a persisting stressor, such as a redox imbalance (251), persistent infection (201, 251), injury (201), insufficient nutrients (201), cold temperatures (201), or it could be due to a defect in the switch that turns off this protective state (251)
