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[95] Intramuscular or intravenous injection [edit] Injection of hydroxycobalamin is often used if digestive absorption is impaired, [2] but this course of action may not be necessary with high-dose oral supplements (such as 0.51.0 mg or more), [97] [98] because with large quantities of the vitamin taken orally, even the 1% to 5% of free crystalline B 12 that is absorbed along the entire intestine by passive diffusion may be sufficient to provide a necessary amount
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This usually presents with ataxia or paraesthesia Subacute combined degeneration of the cord Psychiatric Altered mental state such as confusion, memory problems Cognitive changes such as dementia Loss of mental and physical drive Psychiatric disturbances, ranging from mild neurosis to severe dementia Other Angular cheilosis Anosmia, glossitis, and loss of taste Autonomic complications such as postural hypotension Gait problems consider if history of falls Infertility Investigation of possible malabsorptive process Urinary or faecal incontinence Interpreting investigation results Serum cobalamin The clinical normal level of serum cobalamin is unclear
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