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Clinical signs of B12 deficiency include nausea, vomiting, loss of appetite, poor absorption of food (malabsorption syndrome), constipation, gas, weight loss, fatigue, lethargy, abdominal pain, and diarrhea

After that, the injection frequency usually shifts to a personalized maintenance schedule, which may be biweekly, monthly, or even as needed, based on how you feel and Dr

Malabsorption due to digestive disorders, such as Crohns disease or celiac disease, can also lead to vitamin B12 deficiency

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Most of the product licences, or marketing authorities as they are called in the UK, for hydroxocobalamin date from the 1990s when the requirement for evidence was different than it is now