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Maton PN, Burton ME

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The standard regimen involves: Loading doses without neurological involvement : 1 mg intramuscularly three times a week for 2 weeks [3] [8] Loading doses with neurological involvement : 1 mg intramuscularly on alternate days until no further improvement [3] [8] Maintenance therapy : 1 mg every 23 months for life in cases of pernicious anaemia or irreversible malabsorption (every 2 months if neurological involvement) [3] [8] This aggressive approach aims to prevent irreversible neurological damage, though recovery of established neuropathy may be incomplete, particularly if treatment is delayed

For that reason, it can make Lebers optic atrophy worse, and nobody should ever use it in that case

Most people can after 4 to 6 weeks of gradual buildup