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Consent to publication has been obtained: the Medical Ethics Committee of Shenzhen Longgang Central Hospital approved the publication of the case

Healthcare providers may recommend checking vitamin B12 levels every three to six months during initial treatment, with annual checks once levels stabilize [21]

Patients should report persistent injection-site reactions, severe nausea, chest pain, or shortness of breath to their provider immediately

A deficiency in B12 can lead to a reduction in red blood cell production, resulting in a condition known as pernicious anemia

Schedule: Daily subcutaneous injections for 812 weeks, optionally extended to ~16 weeks for longer research goals