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Prescription and administration: Once B12 deficiency is confirmed, GPs prescribe hydroxocobalamin injections according to standardised protocols: Standard loading regimen: 1mg intramuscularly three times weekly for two weeks Neurological involvement: 1mg intramuscularly on alternate days until no further improvement Maintenance therapy: 1mg every three months for life in pernicious anaemia or malabsorption conditions (or every two months if there was neurological involvement) Injections are typically administered by practice nurses at GP surgeries

Vitamin B12 deficiency is a recognised nutritional complication following bariatric surgery, including gastric banding (laparoscopic adjustable gastric banding, LAGB)

Rarely, people might have allergic reactions like hives or swelling

These findings reinforce the role of IGF-1 in glucose homeostasis

Sterile Syringe: An insulin syringe (typically 1mL/100 units) is perfect for accurate measurement

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