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Providers use blood transfusion only for severe anemia

Anemia Prevention: Vitamin B12 is essential for the production of red blood cells

The answer is that it really depends, but in my experience, MOST patients are fine to use subcutaneous injection-sized needles

[7] In practice, some protocols use 1 mg IM monthly for maintenance once levels are stabilized

It may enhance energy levels, support metabolism, and improve overall wellness

Chemically it is not a peptide at all, so the peptide dosing mental model only partly applies: the reconstitution math is identical, but the route options are broader (a small molecule can survive and be studied by mouth in a way most peptides cannot)