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These can range from mild to severe and may occur shortly after the injection

Yearly monitoring of B 12 status and suitable adjustment of the supplementation dose is recommended.50 For symptomatic deficiency (box 1) caused by insufficient dietary intake, intramuscular B 12 therapy is usually initiated with the aim of progressing to oral supplements once symptoms have resolved.789 Symptomatic deficiency in people with B 12 malabsorption Suggested treatment schemes differ considerably between countries