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The estimated doubling time is 48 hours

This reduces overall efficacy and makes progress assessment impossible

Additional indicators of vitamin B12 deficiency can include difficulty maintaining balance, depression, confusion, dementia, poor memory, and soreness of the mouth or tongue

Who this approach is suitable for When answering the question of who this strategy is intended for, specialists most often refer to patients for whom the quality of healing is critical

Hydroxocobalamin is the form the NHS uses because it lingers in the body longer than cyanocobalamin, and its pharmacology supports dosing intervals of up to three months once levels are stable

In some centres, holotranscobalamin (active B12) may be available as an alternative test