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doi:10.1136/bmj.g5226 18Berth M, Bonroy C, Guerti K, et al

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This is why most treatment protocols recommend receiving injections once or twice per week

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Elderly Patients Older adults often have reduced stomach acid or atrophic gastritis, leading to poor B12 absorption

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Patients should be reviewed 812 weeks after commencing treatment to assess: Symptomatic improvement, particularly resolution of fatigue and neurological symptoms Haematological response (normalisation of haemoglobin and mean cell volume) Reticulocyte count typically rises within one week, indicating bone marrow response Repeat serum B12 testing is generally not useful after starting parenteral therapy, as levels remain elevated for months

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Signalling transduction events involved in agonist-induced PGE2/EP4 receptor externalization in cultured rat dorsal root ganglion neurons

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