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Positive pressure inside the vial from repeated needle insertions can force contaminants back through the needle on subsequent draws, so always equalize pressure by injecting an equivalent volume of air before drawing liquid

Check homocysteine (should be under 9) and MCV (should be 80-92) instead to detect cellular deficiency, even when serum B12 appears normal

Some scientists say using such an approach would be unethical because the current recommendation is to give the vaccine

Injection site infections are rare but require prompt antibiotic treatment when they occur

Bindl L, Ltjohann D, Lentze MJ, von Bergmann K

We use concentrated methylcobalamin at 5000 mcg/ml, the most active and bioavailable form of B12