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The standard UK regimen involves hydroxocobalamin 1mg intramuscularly on alternate days until no further improvement occurs , typically requiring 10–20 injections

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This discrepancy may arise in part because the majority of B12 in serum is bound to the transport protein hapto­corrin which is not physio­logically active and thus unavailable for B12-dependent enzymatic reactions in cells (Green et al., 2017)