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Treatment: There are several ways to supplement B12, including tablets, nasal sprays, and injections

Major Surgery Guideline Statement 22 Major surgery (substitution cystoplasty, urinary diversion with or without cystectomy) may be undertaken in carefully selected patients with bladder-centric symptoms, or in the rare instance when there is an end-stage small fibrotic bladder, for whom all other therapies have failed to provide adequate symptom control and quality of life improvement

Breastfeeding Methylcobalamin is distributed into breast milk in amounts similar to those in maternal plasma, and distribution in breast milk allows for adequate intakes of methylcobalamin by breastfeeding infants

Comparing Injectable and Oral B12 Choices Injectable therapy is not the only form of vitamin B12 replacement