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For severe deficiency, the AAFP recommends loading doses typically daily or every other day for one to two weeks followed by monthly maintenance injections

According to NICE Clinical Knowledge Summaries, the health consequences of untreated B12 deficiencyincluding irreversible neurological damage, megaloblastic anaemia, and cognitive impairmentfar outweigh the inconvenience of manageable acne

Also, the number of participants was very small

Costs depend on your dosing level and supplier

Coeliac disease, inflammatory bowel disease (Crohn's disease or ulcerative colitis), and chronic pancreatitis can all cause both B12 malabsorption and diarrhoea