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Trigger neurologic symptoms, such as numbness and tingling in hands and feet, mood changes, anxiety, difficulty walking, disorientation, and memory loss

Note: For complete details, please review product monographs at and regularly review current Health Canada advisories, warnings and recalls at: for the most up to date information.) Table 4: Treatment of B 12 deficiency (adapted from Means 2021) 27 Note: Intranasal administration is generally not used

Less common

Label vials with date of reconstitution and use by date to track usage

In older adults, secretion of hydrochloric acid in the stomach is reduced significantly, which can lead to poor absorption of vitamin B12