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When the anemia is severe and the red blood cell count is extremely low, blood transfusions may be necessary for the first couple of days until the vitamin B 12 injections begin working

[19] [21] Ascorbic acid, the sole active ingredient in this injection, exerts its physiological effects primarily through its role as a potent antioxidant and enzymatic cofactor

40 High homocysteine is associated with poor response, and high B12 levels with a good response to anti-depressant treatment

B12 deficiency is one of the MOST common nutrient deficiencies and one that is not taken as seriously as it should be

Patients with these risk factors should discuss screening and supplementation strategies with their GP, particularly if experiencing symptoms such as fatigue, paraesthesia, glossitis, or cognitive changes suggestive of deficiency