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If B12 levels are low but still in range indicating a functional deficiency (this is a deficiency but blood tests appear in normal range) then second line testing of homocysteine and MMA can confirm B12 and/or folate deficiency

Once the needle is in place, the anesthetic and steroid medication is injected into the muscle

Frequently Asked Questions About Trigger Point Injections How long does the procedure take

Table of Contents Why Cookie-Cutter B12 Dosing Fails Most People Injection Timing and Location: What Your Doctor Never Told You Using Lab Results to Get Your Dose Right (No More Guessing) Pills vs

Thiamine at 600 to 1,800 mg daily improved fatigue in CFS studies

Treatment should not be delayed if neurological symptoms occur, as nerve damage may become irreversible without prompt B12 replacement