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Patients may experience: Persistent fatigue and weakness Breathlessness on exertion Pallor or a slightly yellowish tinge to the skin Heart palpitations Neurological symptoms are of particular clinical concern, as nerve damage caused by prolonged B12 deficiency can be irreversible if not treated promptly

Repeated use of D64.9 triggers audits

Unless otherwise prescribed by the doctor, the usual dose is: At the beginning of the treatment, 1 ml (1 ampoule) is administered once or twice a week in the first two weeks after the diagnosis, corresponding to 1000 - 2000 g cyanocobalamin per week

The initial loading dose phase is crucial here, providing that quick surge of B12 to help address the neurological effects

Vitamin B-12 is a water-soluble B complex vitamin that is present naturally in a variety of food sources such as fish, meat, and dairy products

Washington DC: The National Academies Press