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Who should not get B12 injections

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Patients with severe MTHFR deficiency (0-20% residual enzyme activity) in infancy or adolescence present with developmental delay, severe mental retardation, motor and gait dysfunction, seizures, psychiatric disturbances, and other neurological abnormalities

Intramuscular (IM) B12 Administration Protocol For those with vitamin B12 deficiency, intramuscular injections are a good treatment

Payers accept it temporarily, but flag repeated use for audit and may reimburse at lower rates

Injectable compounded medications require administration from a medication vial using a syringe/needle (instructions on preparing and injecting the medication are provided)