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Referral to a registered dietitian is appropriate for patients with significant fatigue, rapid weight loss (more than 1-2% body weight per week), or concerns about nutritional adequacy
Leaving vials at room temperature for extended periods
The entire process takes about 5 minutes of active work, plus 15 to 30 minutes of passive dissolution time
The syringe that added water has been in contact with the bacteriostatic water vial stopper and potentially your fingers during the process
Large-scale, well-designed trials with proper randomization and blinding are needed to determine whether high-dose oral supplementation is as effective as intramuscular injection for increasing vitamin B 12 status and alleviating clinical symptoms of vitamin B 12 deficiency
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