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UK standard treatment regimens (per BNF and NHS guidance): Dietary deficiency (e.g., in vegans): oral cyanocobalamin 50150 micrograms daily between meals Pernicious anaemia or other absorption-related deficiency : intramuscular hydroxocobalamin 1 mg on alternate days for two weeks (loading), then 1 mg every two to three months as maintenance

Sleep optimization is particularly important, as sleep deprivation elevates evening cortisol and disrupts normal diurnal rhythm

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It helps regulate blood sugar through its action as a GLP-1 receptor agonist

Palmer SC, Tendal B, Mustafa RA, et al