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The PICOs elements were defined as follows: P (Participants): subjects of any age diagnosed with Vitamin B12 deficiency

Overdosing can irritate the gastrointestinal tract, causing bloating or abdominal cramping

I run a Facebook support group for people living with B12 deficiency and Pernicious Anaemia

Future trials should also measure important outcomes such as the clinical signs and symptoms of vitamin B 12 deficiency, health related-quality of life, socioeconomic effects, and report adverse events adequately, preferably in a primary care setting. Clinical practice guidelines British Columbia Medical Services Commission (MSC)

After approximately 6 months of treatment, 82% of the patients experienced both reduced frequency and intensity of paresthesias and/or dysesthesias