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But here are some general guidelines: Severe deficiencies: Daily shots for 1 week, then weekly shots until levels normalize Moderate deficiencies: Weekly shots until the deficiency is corrected Maintenance dosing : Monthly shots to keep B12 levels optimal Its definitely possible to take B12 shots too often

Patients taking certain medications (e.g., chloramphenicol may reduce the effectiveness of B12 therapy) or with risk factors for B12 deficiency (metformin use, proton pump inhibitors, nitrous oxide exposure, vegan diet) should discuss these with their healthcare provider

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This delayed presentation makes routine monitoring particularly important for all gastric banding patients, regardless of how well they feel in the short term