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When neurological symptoms are present, more intensive treatment is required: 1 mg hydroxocobalamin on alternate days until no further improvement occurs, followed by maintenance therapy every two months

Ballon, J

Pupillary function test in rat: Establishment of imaging setup and pharmacological validation within modified Irwin test

If B12 deficiency is confirmed or strongly suspected in the presence of neurological involvement, same-day parenteral (injectable) B12 treatment should be initiated to prevent irreversible damage

10.1007/s11910-018-0829-3 Curr

Nitrous oxide inactivates vitamin B12 in your body and makes it so your cells cannot use it to complete important processes