Although generally safe, injections should be used with caution in people with a history of allergic reactions to cobalamin or in people with Leber's disease (hereditary optic neuropathy), as B12 may worsen the condition
Frequency Based on Severity : Mild deficiency : Injections may be needed every 3-6 months
According to the American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE) Obesity Clinical Practice Guidelines, weight loss medications should be offered as chronic treatment along with lifestyle modifications to patients with obesity when the potential benefits outweigh the risks
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Furthermore, open-label trials utilizing high-dose hydroxycobalamin have shown marked clinical improvements in ME/CFS patients, specifically correlating with the vitamin's ability to act as a nitric oxide scavenger
For those with more severe deficiencies or absorption problems, B12 injections may be prescribed
