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The main symptoms include: Extreme tiredness Lack of energy Red or sore tongue or mouth Pale skin Changes in mood Changes in movement and balance Feeling pins and needles in arms and feet Reasons for vitamin b12 deficiency Some conditions of the digestive system, such as Chrons disease

Use cautiously in patients with severe allergy history

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The hidden needle reduces anxiety

Additionally, patients should be wary of potential relapses or flare-ups to prevent worsening of symptoms

In the UK, standard maintenance therapy for pernicious anaemia is typically hydroxocobalamin 1mg by intramuscular injection every three months (or every two months if neurological symptoms are present), as per BNF and NICE guidance