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Deficiently of vitamin B12 can lead to abnormal neurologic and psychiatric symptoms including ataxia (shaky movements and unsteady gait), muscle weakness, spasticity, incontinence, hypotension, vision problems, dementia, psychosis, and mood disturbances

Key point: These treatments are not mutually exclusive
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Yearly monitoring of B 12 status and suitable adjustment of the supplementation dose is recommended.50 For symptomatic deficiency (box 1) caused by insufficient dietary intake, intramuscular B 12 therapy is usually initiated with the aim of progressing to oral supplements once symptoms have resolved.789 Symptomatic deficiency in people with B 12 malabsorption Suggested treatment schemes differ considerably between countries

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