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This immediately flags a common cause: Dietary Factors: Vegans and strict vegetarians are at a higher risk of deficiency if they dont consume fortified foods or supplements

As a disulfide bond can be cleaved and hence reduced by the excess concentration of a thiol (sulfhydryl) like -mercaptoethanol (which gets oxidized in the process), the free thiol on glutathione can act as a reducing agent in the cell

Simultaneous administration of hydroxocobalamin and blood products (whole blood, packed red cells, platelet concentrate and/or fresh frozen plasma) through the same intravenous line is not recommended

While most patients tolerate B12 shots well, mild side effects can occasionally occur, including minor pain or redness at the injection site, mild diarrhoea, or, in rare instances, an allergic reaction

As a pediatric ICU nurse, nurse practitioner, and clinical faculty member at some of the countrys most respected institutions, including Childrens Healthcare of Atlanta and Johns Hopkins, she lived and breathed evidence-based medicine, patient safety, and quality improvement

Gao R-R, Han C, Sui G-Y, et al