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Critics, including the FDA's own scientific staff, argue that insufficient evidence exists to ensure these compounds are safe for human use

Nursing interventions should be: Safe and appropriate for the clients age, health, and condition

Supplementation strategies vary depending on the underlying cause of deficiency or risk factors: Oral supplements (typically 25-2000 micrograms daily) are suitable for individuals with adequate intrinsic factor production but insufficient dietary intake Sublingual or buccal preparations have no proven superiority over standard oral tablets at equivalent doses Intramuscular injections (usually 1000 micrograms of hydroxocobalamin) are the preferred treatment for pernicious anaemia and severe malabsorption

doi: 10.1002/jps.20094 195 PardridgeW