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Furthermore, laboratory testing can detect associated electrolyte and acid-base disturbances but determination of circulating electrolytes and acid-base balance is typically limited to children requiring intravenous fluids

Medical advice is recommended if you: Have not had a period for more than three months Experience unusually heavy bleeding Develop severe or recurring period pain ( Manage Period Pain ) Notice your cycles becoming consistently irregular Experience dizziness or fainting Find that symptoms are affecting your daily life Have unexplained weight loss or concerns about hormonal changes Adults who usually have regular periods should consider seeking medical advice if pregnancy is possible or if symptoms may be linked to conditions such as PCOS or thyroid disorders

Progress by no more than 10 to 15 percent per week

The standard schedule is a starting point, not a strict rule The 2024 NICE guideline NG239 on B12 deficiency in over 16s makes an important point: the optimal route, dose and frequency of B12 replacement have never been firmly established, and have often followed custom and historical practice