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For most patients with vitamin B12 deficiency, high-dose oral supplements are as effective as intramuscular injections at raising serum B12 levels and resolving symptoms

peak blood concentrations of the vitamin are not achieved for 6 to 8 hours after an oral dose

Other symptoms may include: Glossitis (sore, red tongue) Mouth ulcers Visual disturbances (rare, due to optic neuropathy, requiring urgent assessment) Gastrointestinal symptoms such as diarrhoea or constipation It is crucial to recognise that neurological damage from B12 deficiency can become irreversible if left untreated for prolonged periods

The manufacturer of Omnitrope recommends leaving the medication out for 30 minutes before injecting a dose in order to bring the drug to room temperature

There are several different forms of vitamin B12, usually known as cobalamin (Cbl), including cyano-, methyl-deoxyadenosyl-, and hydroxy-cobalamin

PMID 31712552