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For milder vitamin B12 deficiency, where circumstances make delay difficult, there may be room for discussion of enhanced perioperative supplementation (such as intramuscular B12 close to surgery and continued through recovery)

Improvements may lead to immune suppressing medication no longer being required or in dose reduction of those agents

A typical pediatric b12 iv dose for deficiency is 100 mcg daily for 5-10 days, followed by a maintenance dose of 100-200 mcg monthly

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Systemic allergic reactions to the benzyl alcohol in bacteriostatic water are extremely rare, especially given the small amounts used, but as with any injection, if you were to develop symptoms like hives, difficulty breathing, or low blood pressure after an injection, seek medical care

MACS is associated with a high burden of cardiometabolic comorbidities, most commonly hypertension (80%) and diabetes (40%) [176]