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At the beginning of the treatment, 1 ampoule with 1 mlvitamin B 12 Lichtenstein (corresponding to 1000 micrograms of cyanocobalamin) is added twice a week in the first weeks after diagnosis.12 Lichtenstein is usually administered intramuscularly (injected into a muscle)

Less Common Side Effects Fatigue After Vitamin B12 Injection Although Vitamin B12 is typically used to combat fatigue, some individuals may experience increased tiredness post-injection

Intramuscular injection bypasses the gut entirely for complete, immediate absorption

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Extrapolating from B12 supplementation trials of non-vegans to determine the needs of vegans is complicated by the fact that a high percentage of any small dose of B12 is absorbed and omnivores are normally receiving numerous small doses throughout the day