In Doctor Koshiba's expert opinion, the alternative on offer - high-dose oral B12 (typically 1000-2000 mcg daily) - can be quite effective for many people
If the step therapy policy was not followed, this can lead to a costly claim denial that may not have appeal rights
Symptoms of B12 deficiency Vitamin B12 deficiency is relatively common, especially among older people
Application in Studies of Hepatic Metabolic Disorders and Fatty Liver Disease The liver is a central metabolic organ responsible for lipid, glucose, and protein metabolism
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A nasal spray is also available but is not considered the best treatment for severe deficiency because B12 is not absorbed as well as it is via injection