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While themes 16 relate to veterinary medical prescriptions, they lack focus on oral medications

UK guidance recommends hydroxocobalamin 1mg intramuscularly with dosing frequency determined by presence of neurological involvement

However, research supporting their efficacy is limited, and they are generally not recommended for those with severe deficiencies

Additionally, chronic conditions such as HIV and tuberculosis have been implicated in B12 deficiency due to increased metabolic demand and altered absorption mechanisms ( The diagnosis of vitamin B12 deficiency typically relies on low total B12 levels and elevated concentrations of homocysteine (Hcy), as well as levels of transcobalamin-bound B12 (holoTC) and methylmalonic acid (MMA), which serve as functional indicators of cobalamin insufficiency ( Vitamin B12 requirements fluctuate throughout the life course, influenced by metabolic demand and physiological changes

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