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Hydroxocobalamin is the standard UK preparation, administered intramuscularly for conditions like pernicious anaemia and gastrointestinal malabsorption B12 acts as a cofactor in DNA synthesis, red blood cell formation, and nervous system function, supporting energy metabolism pathways Common side effects include injection site reactions, mild gastrointestinal upset, and temporary urine discolouration, with serious reactions being rare NHS access requires GP assessment with blood tests

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He has a history of many years of symptoms, multiple interventions (extensive physical therapy, multiple surgeries), and multiple corticosteroid injections

Early determination of androgen-responsiveness is important in the management of microphallus