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Per BNF and BSH guidance: For confirmed deficiency without neurological involvement: 1 mg IM on alternate days for two weeks, then 1 mg every two to three months for maintenance

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However, certain populations are at higher risk of deficiency: Adults over 50 (reduced absorption capacity) Individuals following vegan or strict vegetarian diets Those with gastrointestinal conditions such as Crohns disease or celiac disease Individuals taking long-term acid-reducing medications (PPIs, H blockers) When oral supplementation is insufficient or absorption is compromised, vitamin B12 shots deliver the nutrient directly into the bloodstream, bypassing the digestive system entirely