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According to British Society for Haematology (BSH) guidelines and NICE Clinical Knowledge Summaries (CKS), the primary beneficiaries include: Key patient groups who may require B12 injections include: Pernicious anaemia patients requiring lifelong hydroxocobalamin 1mg intramuscularly every 23 months following initial loading doses Patients with gastrointestinal disorders including those who have undergone gastrectomy or ileal resection, and patients with conditions affecting B12 absorption such as Crohn's disease or coeliac disease Strict vegans and vegetarians though oral supplementation is usually sufficient unless malabsorption is present Elderly patients who may have reduced gastric acid production affecting B12 absorption Patients taking certain medications including metformin (MHRA advises monitoring B12 levels in long-term users, particularly those with risk factors or symptoms), proton pump inhibitors, and H2-receptor antagonists long-term [6] Individuals with neurological symptoms such as paraesthesia, ataxia, or cognitive impairment related to B12 deficiency Pregnant women with confirmed deficiency (hydroxocobalamin for malabsorption

May also improve body composition by aiding with glycolysis (sugar metabolism) and lipolysis (fat metabolism)

Vitamin B12 deficiency is common and can manifest at any age and is largely unrecognised

Purple toe syndrome is thought to be due to small emboli (blood clots) in the blood vessels which cause a bluish-purple color in the toes and feet

Journal of Applied Physiology