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The formulation is compounded by a licensed pharmacy and administered intramuscularly or subcutaneously, typically 0.5-1 mL weekly

Reusable pens (with replaceable cartridges) may have higher initial costs but lower long-term costs for high-volume settings like clinics

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While this idea is somewhat simplified, its intriguing His hypothesis suggests that the sudden influx of B12 can kickstart repair processes, and if there has been long-standing damage, the rapid onset of these processes might overwhelm the system, causing a temporary worsening of symptoms

Patients may also choose to have their prescription sent to a local pharmacy through LSH, but pricing and availability can vary by pharmacy