According to the NICE Clinical Knowledge Summary (CKS) and the British National Formulary (BNF) , the standard treatment for B12 deficiency without neurological symptoms involves: Hydroxocobalamin 1 mg intramuscularly three times weekly for two weeks Followed by maintenance doses of 1 mg every three months For patients with neurological symptoms (such as paraesthesia, numbness, cognitive changes, or gait disturbances), more intensive treatment is required: Hydroxocobalamin 1 mg intramuscularly on alternate days until no further improvement occurs Followed by 1 mg every two months for maintenance Pernicious anaemia , an autoimmune condition where the body cannot produce intrinsic factor, requires lifelong treatment
Doctors often recommend it as part of long-term therapy for patients who have absorption problems or cannot maintain sufficient B12 through diet alone
These visits may carry their own fees, which will be explained to you during your initial consultation
Starting metformin at a low dose (500 mg once or twice daily) and gradually increasing over several weeks allows for more gradual glucose reduction, potentially minimizing the magnitude of osmotic lens changes
Were a community pharmacy, not a pop-up clinic
