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In the UK, hydroxocobalamin 1 mg intramuscular injection is used: Without neurological involvement : 1 mg three times weekly for two weeks, then maintenance of 1 mg every two to three months With neurological involvement : 1 mg on alternate days until no further improvement in symptoms, then maintenance of 1 mg every two months Lifelong maintenance is required for pernicious anaemia or other irreversible causes of deficiency Oral B12 supplementation may be appropriate for diet-related deficiency in patients without neurological symptoms and with adequate absorption capacity

Book now M W Phillips House 121 Shady Lane Great Barr Birmingham B44 9ET Telephone: 0121 355 4200 Why Vitamin B12 matters Vitamin B12 supports red blood cell production, nervous system health and energy release from food

Risk factors that should prompt consideration of B12 deficiency include advancing age (reduced stomach acid production), strict vegan or vegetarian diets, pernicious anaemia, gastrointestinal surgery (particularly gastric bypass or ileal resection), long-term use of certain medications (metformin, proton pump inhibitors, H2-receptor antagonists), nitrous oxide exposure (including recreational use), and conditions affecting the gut such as Crohn's disease or coeliac disease

As a tumor grows in the spine, it can damage the bone, weakening it until it fractures and collapses

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