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Optic nerve damage: Particularly in individuals with Leber's disease, a hereditary condition that causes retinal degeneration and blindness in children
Including cyanocobalamin in the injection ensures adequate B12 replacement to prevent neurological complications and megaloblastic anemia that can develop over months of restricted intake
PMID 19289127
Setria Lglutathione has human data showing rises in blood glutathione within 4 to 12 weeks, with modest drops in oxidative markers in responders
GPs can prescribe B12 injections following appropriate investigation, which should include: Full blood count to identify macrocytic anaemia Serum B12 and folate levels to confirm deficiency (using laboratory-specific reference ranges) Methylmalonic acid and/or homocysteine when B12 results are borderline Intrinsic factor antibodies if pernicious anaemia is suspected Additional tests depending on clinical presentation (e.g., thyroid function, coeliac serology) When both B12 and folate deficiency are present, B12 should be replaced before folate to avoid precipitating subacute combined degeneration of the spinal cord
