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Injections (commonly hydroxocobalamin in the UK) Oral supplements Oral B12 can be helpful in some cases, especially where deficiency is dietary and absorption is adequate

B12 injections are not meant to replace a healthy lifestyle

Metformin may also increase liver accumulation of B12, meaning it is less available, and it may alter reabsorption of bile acids, disrupting the enterohepatic circulation of B12

My triggers were tiredness, combined with not drinking/eating enough or getting stressed

In addition, the negative NMO and MOG antibody tests effectively rule out neuromyelitis optica and MOG-associated disorders as alternative causes, leaving the possibility of clinically isolated syndrome (CIS) or an early demyelinating condition, such as multiple sclerosis (MS), as more probable explanations