Cyanocobalamin formulations contain trace amounts of cyanide and are contraindicated in patients with Leber's hereditary optic neuropathy
No significant long-term risks have been identified in published research
Wadia NH, Desai MM, Quadros EV, Dastur DK
Hydroxocobalamin 1mg is the standard UK formulation, typically administered every two to three months for maintenance therapy Self-administration requires GP prescription, competency training from practice nurses, and demonstration of proper injection technique Common injection sites include the thigh (vastus lateralis) for both intramuscular and subcutaneous administration with site rotation essential Serious side effects are rare but anaphylaxis requires immediate 999 call
While there's no one-size-fits-all approach, healthcare providers typically recommend supplementation to prevent potential deficiencies
Signs You May Have Low Vitamin B12 Tingling or numbness in the feet Burning or stabbing nerve pain Fatigue, and weakness while walking Balance problems Blood testing is recommended before treatment where possible