Nutritional Supplementation
Recommended daily allowance (RDA)
>19 years: 2.4 mcg
Pregnant women: 2.6 mcg
Breastfeeding women: 2.8 mcg
Dietary supplement: 50-6,000 mcg/day
Pernicious Anemia
Manufacturer recommendation: 100 mcg IM/SC once daily for 6-7 days, then every other day for 7 doses, then every 3-4 days for 2-3 weeks, then monthly
Alternative parenteral dosing: 1000 mcg IM/SC once daily for 7 days, then weekly for 1 month, then monthly
Nasal spray: 500 mcg (1 spray in 1 nostril) weekly; if patient is taking hot meals, spray should be administered 1 hour before or after meal
B12 Deficiency
Initial: 30 mcg IM once daily for 5-10 days
Maintenance: 100-200 mcg IM monthly
Nasal dose: 500 mcg once weekly