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Oral supplements: Methylcobalamin or cyanocobalamin tablets (500-1,000 mcg/day) Absorption via passive diffusion (not requiring intrinsic factor) at high doses Effective for dietary deficiency in people with normal gut function Takes 3-6 months to normalize serum levels Sublingual (under-tongue) tablets: Absorbed directly through the oral mucosa — bypasses gut absorption issues Preferred for mild-moderate deficiency and absorption issues Better than oral tablets for metformin users and older adults Intramuscular (IM) injections: Hydroxocobalamin or methylcobalamin injections — bypasses gut completely Standard protocol for severe deficiency or confirmed absorption disorders (pernicious anemia) Faster normalization (weeks rather than months) Recommended for patients with significant neurological symptoms or anemia At Assure Clinic: Patients presenting with suspected B12-related hair loss receive a blood panel as part of their pre-treatment assessment

Magnesium Sulfate for Injection

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