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An insufficient clinical response to B12 treatment during the first weeks of therapy should not routinely lead to the discontinuation of treatment

no aspiration) CDC (Subcut Injection PDF) Technique diagram and site guidance for subcutaneous injections NCBI Bookshelf Best practices for injection (asepsis, preparation, and administration) Additional Research and Background These sources provide related context and are not presented as support for a specific statement above

The pancreatic secretion of intrinsic factor is reduced or absent, secondary dysbiosis of the intestine is common, and the mucosa may be compromised by the presence of excessive bacterial numbers and toxic metabolites