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Given the safety, relative low cost, and significant affect cobalamin deficiency can have on quality of life, we recommend B12 supplementation for all emaciated patients, regardless of whether access to serum cobalamin testing is available

[DOI] [PubMed] [Google Scholar] 48.Scenario: management of anaemia - vitamin B 12 and folate deficiency

AllergyNet Adverse reactions to vitamin B12 injections due to benzyl alcohol sensitivity successful treatment with intranasal cyanocobalamin S

The quaternary ammonium structure suggests poor passive membrane permeability, which would limit intestinal absorption

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