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15,17-19 A needle that is too long may pass through the deltoid muscle and hit the bone instead

Sublingual and nasal B12 sublingual tablets (dissolved under the tongue) and nasal B12 sprays have shown effectiveness for deficiency correction as needle-free alternatives but only when the gut absorption mechanism is intact

We will analyse the effect of vitamin B 12 separately in the following subgroups: Vitamin B 12 status: based on cobalamin (cut-off: 150 pmol/L) based on low total homocysteine (cut-off: 10 mol/L) based on low methylmalonic acid (cut-off: 0.26 mol/L) Maternal body mass index (cut-off: 18.5) Vegetarian (yes/no) Birth weight (cut-off: 2500 g) In these subgroup analyses, the differences in the effect between the levels of the subgroups will be measured by including two-way interaction terms in multiple regression models

The role of metformin on vitamin B12 deficiency: a meta-analysis review. Internal and emergency medicine 10 (2015): 93-102