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These symptoms may suggest inadequate B12 replacement, concurrent iron or folate deficiency, or alternative haematological conditions requiring investigation

Conflict of interest The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest

PAS is actively collaborating with researchers to investigate the metabolic reasons as to why some patients need shorter intervals between doses (e.g., monthly or every six weeks and in some instances even more frequently) to maintain their quality of life

Turn the vial and syringe upside down so the needle points upward, and pull back on the plunger to withdraw the correct amount of medication

The fundamental issue is the lack of education, awareness and respect demonstrated by many GPs to patients seeking a diagnosis or treatment