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The frequency of B12 injections varies based on the severity and cause of deficiency: For significant deficiencies or pernicious anemia, daily or weekly shots may be started, then tapered to monthly maintenance doses

Vigorous shaking creates foam and may denature the peptide through mechanical stress

Compounded medications are not FDA-approved

The most speculative

Symptoms of a B12 deficiency include: Excessive fatigue Nerve problems (pain or abnormal sensations like numbness or tingling) Glossitis (tongue inflammation) Low numbers of white blood cells and red blood cells Vitamin B12 deficiency can be diagnosed with a blood test

People taking certain common medications including metformin for blood sugar management and proton pump inhibitors for acid reflux also face increased deficiency risk