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Buy larger vials when appropriate Cost per milligram typically decreases with larger vial sizes

A blood test can be helpful to confirm deficiency, but it is not always required

For pre-filled pens or auto-injectors, follow the manufacturer's instructions to prepare the device for injection

After that, they continue with monthly maintenance

People on diabetes medications Vegetarians (and vegans) Elderly People on anti acids People with Crohns Disease, Ulcerative Colitis, Celiac Disease or Irritable Bowel Syndrome (IBS) Women with a history of infertility and miscarriage How often should one get vitamin B12 injections