Do I need a blood test beforehand
Pharmacokinetics: Cyanocobalamin is administered intranasally, orally, and parenterally, while hydroxocobalamin is administered only parenterally. Once absorbed, vitamin B12 is highly bound to transcobalamin II, a specific B-globulin carrier protein and is distributed and stored primarily in the liver as coenzyme B12. The bone marrow also stores a significant amount of the absorbed vitamin B12. This vitamin crosses the placenta and is distributed into breast milk. Enterohepatic recirculation conserves systemic stores. The half-life is about 6 days (400 days in the liver). Elimination is primarily through the bile; however, excess cyanocobalamin is excreted unchanged in the urine
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However, if any particulate matter remains undissolved or the solution remains cloudy, the vial should be discarded for safety
If you find the 45 unit mark uncomfortably small to read, the honest options are (a) use a finer-gradation syringe, or (b) follow a protocol built around the 50 mg vial, whose larger draw is more forgiving not to freehand a bigger volume from the 10 mg vial, which would silently overdose relative to the documented figure