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NICE and British National Formulary (BNF) guidance recommend 1 mg hydroxocobalamin on alternate days until no further improvement in symptoms is observed

Falutz J, Allas S, Mamputu JC, et al

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[26] A complication of severe chronic PA is subacute combined degeneration of spinal cord, which leads to distal sensory loss (posterior column), absent ankle reflex, increased knee reflex response, and extensor plantar reflex response

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5-Amino-1MQ is typically administered orally or via subcutaneous injection at research doses ranging from 50mg to 100mg daily