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The standard regimen involves: Loading doses without neurological involvement : 1 mg intramuscularly three times a week for 2 weeks [3] [8] Loading doses with neurological involvement : 1 mg intramuscularly on alternate days until no further improvement [3] [8] Maintenance therapy : 1 mg every 23 months for life in cases of pernicious anaemia or irreversible malabsorption (every 2 months if neurological involvement) [3] [8] This aggressive approach aims to prevent irreversible neurological damage, though recovery of established neuropathy may be incomplete, particularly if treatment is delayed

doi: 10.1038/372425a0