According to the NICE Clinical Knowledge Summary (CKS) and the British National Formulary (BNF) , the standard treatment for B12 deficiency without neurological symptoms involves: Hydroxocobalamin 1 mg intramuscularly three times weekly for two weeks Followed by maintenance doses of 1 mg every three months For patients with neurological symptoms (such as paraesthesia, numbness, cognitive changes, or gait disturbances), more intensive treatment is required: Hydroxocobalamin 1 mg intramuscularly on alternate days until no further improvement occurs Followed by 1 mg every two months for maintenance Pernicious anaemia , an autoimmune condition where the body cannot produce intrinsic factor, requires lifelong treatment
New research shows that eating animal products causes animal sugars, such as Neu5Gc, to become attached to cells that line our hollow organs, like the stomach, causing the body to make antibodies against these sugars resulting in chronic inflammation and, therefore, impaired B12 absorption
Neither BPC-157 nor TB-500 is FDA-approved, and the FDA has specifically flagged BPC-157, so these remain research-stage compounds discussed only in a wellness-support context
This is especially important for women and anyone over 40, populations where muscle preservation during weight loss is critical for long-term metabolic health
