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Vitamin B12 injections are given intramuscularly for those with a B12 deficiency related to age, pernicious anaemia, or low levels caused by a vegan or restrictive diet without supplementation

Older adults, and those on long-term medications for acid reflux, might also be at risk

Polyanalgesia, although more costly (dual therapies average $6.07/d and triple therapies $10.40/d, compared with monotherapy at $2.80/d), is justified based on its effectiveness in restoring pain control

An elevated methylmalonic acid (MMA) level has been thought to be the most direct, metabolic indicator of B12 deficiency because B12 is the only cofactor required by the enzyme that degrades MMA

Vitamin B12 is vital for nervous system function and brain health