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Intramuscular hydroxocobalamin injections are the recommended first-line treatment in the UK, as they bypass the absorption problem caused by lack of intrinsic factor

HMG-CoA reductase inhibitors (statins) to reduce cellular production of cholesterol Medications to lower cholesterol absorption from the intestine (eg bile acid sequestrants like colesevelam) PCSK9 inhibitors, which allow LDL to bond to its receptors and be removed from the blood For people who require additional LDL lowering, the new drug bempedoic acid may be recommended in addition to statin therapy

Most non disease-specific guidelines suggest a daily or alternate day dose of 1000 g of intramuscularly B12 for 2 weeks and then a transition to a monthly regimen (Kramarz et al

Reverse the sequence5-Amino-1MQ must come first

Richard MA, Lupo PJ, Zachariah JP

Inject once daily, subcutaneously, rotating between the abdomen, thighs, and upper arms