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Cyanocobalamin : Synthetic form, requires conversion to active B12, longer shelf life, lower cost Methylcobalamin : Bioactive form, immediate utilization, preferred for neurological symptoms, more expensive Hydroxocobalamin: Used for cyanide poisoning, longest-acting Standard dose: 1000mcg/ml Routes: Deep IM (gluteal/deltoid) or subQ (abdominal) Loading phase: Daily/weekly for 1-4 weeks Maintenance: Monthly or every 3 months (hydroxocobalamin) No need for aspiration before injection Oral absorption requires intrinsic factor (absent in pernicious anemia) and healthy ileum

Although the system has comparable capabilities as the da Vinci system, we think that due to its simplicity it would most likely be employed in high volume procedures

MW: 152.2 Da

This two-step injection protocol is known to induce OA-like cartilage degeneration, particularly in the lateral portion of the femoral condyle

What Is a B12 Shot and How Does It Work