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The standard schedule is a starting point, not a strict rule The 2024 NICE guideline NG239 on B12 deficiency in over 16s makes an important point: the optimal route, dose and frequency of B12 replacement have never been firmly established, and have often followed custom and historical practice
This guide reflects the current landscape as of June 2026
The hydrolysis of extracellular Gln by the GGT from gastric helicobacters can cause a depletion of this conditionally essential amino acid in the gastric juice of an infected host, which may eventually lead to epithelial cell damage and immunological dysfunction 16,18,20
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