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The proposed study examines the questions that, according to the Cochrane review mentioned above [3], are still to be answered, via a clinical trial (of ample duration and with a large number of patients) in the primary healthcare setting

These included: Expressive communication Personal and domestic daily living skills Interpersonal skills Play-leisure skills Coping social skills Other clinical improvements observed with B12 included improvements in: Sleep Gastrointestinal symptoms Hyperactivity Tantrums Nonverbal intellectual quotient Vision Eye contact Echolalia Stereotypy Anemia Nocturnal enuresis (bed wetting) Adverse events with B12 identified by meta-analysis included: Hyperactivity (11.9%) Irritability (3.4%) Trouble sleeping (7.6%) Aggression (1.8%) Worsening behaviors (7.7%) But adverse effects were generally few, mild, not serious, and not significantly different compared to placebo

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We really need more information on this important topic: Why do some individuals need more frequent B12 injections than others

doi: 10.1038/nri1778 54 SilvagnoFVernoneAPescarmonaGP