why would you need vitamin b12 injections for an ileostomy Do patients to take supplements? Best Vitamin B12 Injection Site:

Lifelong intramuscular vitamin B12 replacement is recommended for patients with deficiency caused by autoimmune gastritis, pernicious anaemia, total gastrectomy or terminal ileum resection (Table 4),19 because these conditions irreversibly impair gastrointestinal absorption, making oral B12 unreliable or ineffective even at high doses

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In clinical and applied settings, there is a need to transition from generalized, one-size-fits-all approaches toward more individualized, cycle-aware strategies that account for temporal metabolic variability

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Vitamin B12 There is four types of parenteral Vitamin B12 available: Cyanocobalamin 100 mcg/ml and 1000 mcg/ml best used as IM to prevent rapid loss via kidneys Hydroxycobalamin IM (compounded 1000 mcg/ml or more) known as long acting B12 (binds better to plasma proteins than cyanocobalamin) Methylcobalamin IV (compounded 1000 mcg or more up to 5000 mcg/ml) Adenosylcobalamin IV Common dose is 1000 mcg IM or IV Vitamin B12 as hydroxycobalamin is synthesized exclusively by microorganisms and is found in the liver of animals bound to protein as methylcobalamin = metabolically active form of Vitamin B12 Hydroxycobalamin is a chelator of cyanide and is used in cyanide poisoning Hydroxocobalamin is most generally used for vitamin B12 replacement therapy and is considered the drug of choice for vitamin B12 deficiency by the Martindale Extra Pharmacopoeia (Sweetman, 2002) and the World Health Organization (WHO) Model List of Essential Drugs