This protocol addresses malabsorption in patients with vitamin B12 deficiency whose underlying condition makes oral absorption unreliable — specifically those with a history of total gastrectomy, extensive ileal resection, or ongoing malabsorptive disease.
In patients with these anatomical or functional barriers to absorption, the intramuscular route of B12 administration is indicated, bypassing the gastrointestinal tract entirely. Standard oral supplementation cannot be relied upon in this population.
Correction of vitamin B12 deficiency with normalisation of vitamin B12 levels. In malabsorptive syndromes, micronutrient deficiencies should be systematically screened and properly corrected.
Management involves a parenteral cobalamin replacement strategy delivered by intramuscular injection. The specific dosing regimen, interval, and monitoring parameters are detailed in the full structured protocol.