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In those cases, preservative-free sterile water for injection (without benzyl alcohol) is required

However, some evidence suggests that supplements of 25 mcg per day or higher may increase the risk of bone fractures

Other symptoms of vitamin B12 deficiency Other symptoms of the condition are listed by Bupa as: Feeling very tired Breathlessness even after a little exercise Heart palpitations Headaches A reduced appetite A sore mouth and tongue The health organisation adds: If you have vitamin B12-deficiency anaemia, you may also look pale or jaundiced (have a yellowy tinge to your skin and the whites of your eyes)

The body requires enough time to absorb sufficient supplement levels from oral sources, particularly when the deficiency reaches severe levels