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Because the injection allows for direct absorption, the effects are typically felt much more quickly than with oral supplements

Morning injections are recommended, ideally 30 minutes before breakfast

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In the UK, standard maintenance therapy for pernicious anaemia is typically hydroxocobalamin 1mg by intramuscular injection every three months (or every two months if neurological symptoms are present), as per BNF and NICE guidance

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A single gene deletion results in a silent carrier stateclinically asymptomatic but detectable through genetic testing