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As far as the PA Society is concerned we want patients who are newly diagnosed to be offered a choice of treatment based on the patients individual needs

If dietary sources are insufficient, however, a doctor may recommend supplementation through pills or injections, depending on the cause of the deficiency.

While these injections are generally safe with minimal side effects, you may experience mild soreness or redness at the injection site

Intramuscular therapy leads to more rapid improvement and should be considered in patients with severe deficiency or severe neurologic symptoms

After that, you may shift to once-a-week injections for one to two months, and then to monthly injections