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Figure 1: B 12 Test Result Review and Process Algorithm for Patients with Risk Factor for B 12 Deficiency* and/or Non-specific** or Specific Symptom of B 12 Deficiency TOP Management Treatment In suspected B 12 deficiency, supplement both B 12 and folate

Pre-filling syringes reduces effective dose by 58% over 24 hours due to peptide adhesion to syringe walls, which compounds across multi-day protocols and undermines dosing consistency

Discuss combination approaches during your physician consultation

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The patient should be questioned closely about any symptoms from previous doses to prevent severe reactions