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[1] Because intrinsic-factor-dependent uptake in the distal ileum can be absent in conditions such as autoimmune gastritis, pancreatic insufficiency, or bariatric surgery, the intramuscular or subcutaneous route bypasses gastrointestinal barriers and reliably restores serum concentrations

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For people with problems absorbing the vitamin, pregnant women, and individuals suffering from mild deficiency, a 1000 mcg dose may be recommended

Monitoring Protocol: Although the trials showed no concerning laboratory changes, prudent clinical practice suggests baseline and periodic monitoring of metabolic parameters, complete blood counts, liver function, and kidney function

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Adjust dose based on response and tolerance