1000mcg vitamin b12 injection Cyanocobalamin (Vitamin B12) 1000 mcg/mL, Multiple Dose Vial 1 mL, 25/Tray dogs and horses as needed Cyanocobalamin Vitamin B12 Injection, 1

Increased intestinal permeability is facilitated by a high-fat diet (HFD) 22 , and may allow for bacterial translocation from the gut to adipose tissue 23

The NHS treatment pathway and the 2024 NICE guideline both assume B12 injections are given in a clinical setting against a confirmed deficiency, not self-sourced and self-administered

Some research from Germany has shown that an even higher threshold (over 500 pg/mL) is necessary in early-to-mid pregnancy to maintain vitamin B12 levels throughout pregnancy, lactation, and to support an infants vitamin B12 status (via breast milk) through 6 months of age

The MHRA recommends considering periodic B12 monitoring in patients on metformin who have risk factors for deficiency, and testing if symptoms develop

Monthly Dosing Volumes How often you get vitamin B12 shots can change, from weekly to monthly

Figure 5: Changes in tissue weight in lean mice and obese mice across the three different experimental treatment groups