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The dosing regimen varies depending on whether neurological symptoms are present: With neurological involvement: 1 mg intramuscularly on alternate days until no further improvement, then 1 mg every 2 months [3] [4] Without neurological involvement: 1 mg intramuscularly three times a week for 2 weeks, then 1 mg every 2-3 months for maintenance [3] [4] There is some evidence that high-dose oral B12 (1000-2000 micrograms daily) may be effective even in some malabsorption conditions, though UK practice still generally favours intramuscular treatment in these cases

Patients at this age have also been reported to have a high prevalence of vitamin B 12 deficiency, with estimates of up to 20% in the elderly
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doi: 10.1182/blood-2005-07-2913 18 DeaglioSZubiaurMGregoriniABottarelFAusielloCMDianzaniUet al

G., Sallam, T., Martin-Montalvo, A., Wan, J., Kim, S
