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The dosing regimen varies depending on whether neurological symptoms are present: With neurological involvement: 1 mg intramuscularly on alternate days until no further improvement, then 1 mg every 2 months [3] [4] Without neurological involvement: 1 mg intramuscularly three times a week for 2 weeks, then 1 mg every 2-3 months for maintenance [3] [4] There is some evidence that high-dose oral B12 (1000-2000 micrograms daily) may be effective even in some malabsorption conditions, though UK practice still generally favours intramuscular treatment in these cases

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[DOI: 10.1186/1471-2288-5-13] [DOI] [PMC free article] [PubMed] [Google Scholar] Hrbjartsson 2013 Hrbjartsson A, Thomsen AS, Emanuelsson F, Tendal B, Hilden J, Boutron I, et al

Timing can vary depending on your protocol, so it is important to align probiotic use with your overall treatment strategy