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Doses as high as 2 mg (2,000 g) daily by mouth or 1 mg monthly by intramuscular (IM) injection have been used to treat pernicious anemia without significant side effects (136)

High-dose injectable Cyanocobalamin, used for treating severe deficiencies like pernicious anemia, typically requires a prescription from a doctor

[19] The enzymes that use B 12 as a built-in cofactor are methylmalonyl-CoA mutase (PDB 4REQ [43] ) and methionine synthase (PDB 1Q8J)

Studies suggest that up to 30% of patients hospitalized for depression are deficient in B12, and that B12 concentrations in blood are generally lower in depressed patients than nondepressed patients