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Individuals with risk factors for B12 deficiency including strict vegans, those with gastrointestinal conditions, patients taking long-term metformin or proton pump inhibitors, and older adultsshould discuss screening with their GP, even in the absence of obvious symptoms

Both of these are felt to be equally effective, but the SQ approach uses a smaller needle size and is felt to be more comfortable

Large-scale trials have not shown increased rates of thrombotic events compared to placebo, and the FDA prescribing information does not list blood clots as a recognized adverse effect

This approach, guided by regular blood testing, can optimize both effectiveness and cost-efficiency

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B-vitamin deficiency causes hyperhomocysteinemia and vascular cognitive impairment in mice