Lower concentration, larger draw volume per dose
Tracking and adjusting Keep a protocol journal
Certain populations need to inject B12 in larger doses to maintain baseline health: Individuals with pernicious anemia are initially injected with 100 mcg daily for one week, followed by 100 mcg every other day for 3-4 weeks
A consultation is especially important if you: Have a known allergy to B vitamins or any of the MIC components Are pregnant, breastfeeding, or trying to conceive Have kidney disease, liver disease, or a history of kidney stones (methionine metabolism can affect uric acid and homocysteine levels) Take blood thinners, immunosuppressants, or medications that interact with B12 absorption (such as metformin) Have a sulfa allergy (methionine is a sulfur-containing amino acid) Have a trimethylaminuria (fish-odor syndrome) diagnosis, which affects choline metabolism Have a history of cardiovascular events or uncontrolled hypertension This list is not exhaustive, and it is not a substitute for an individualized assessment
Vitamin B12 can be injected just under the skin, or directly into the muscle
Documentation completeness including etiology, nerve distribution, fiber type, and response to treatment is essential for accurate ICD-10-CM coding, appropriate HCC risk capture, and demonstration of quality care to payers and accreditors
