Before starting Vitamin B12 Injection, it is crucial to discuss potential side effects and risks with your doctor or pharmacist
Total gastrectomy always produces vitamin B12 deficiency
Cyanocobalamin : Synthetic form, requires conversion to active B12, longer shelf life, lower cost Methylcobalamin : Bioactive form, immediate utilization, preferred for neurological symptoms, more expensive Hydroxocobalamin: Used for cyanide poisoning, longest-acting Standard dose: 1000mcg/ml Routes: Deep IM (gluteal/deltoid) or subQ (abdominal) Loading phase: Daily/weekly for 1-4 weeks Maintenance: Monthly or every 3 months (hydroxocobalamin) No need for aspiration before injection Oral absorption requires intrinsic factor (absent in pernicious anemia) and healthy ileum
Although dietary fiber has been associated with microbiome changes 75 , this is unlikely to account for the microbiome changes observed herein since fiber content was the same across diets
Before we get into cost, it helps to know what youre paying for
