Problem: What about this: The treatment plan for pernicious anemia is often lifelong supplementation of vitamin B12 (Norris, p. 579, 2019). Intramuscular or sublingual routes of vitamin B12 are the best plan for replenishment because it does not require absorption in the stomach (Means & Fairfield, 2024b). According to UpToDate, an "initial dose of 1000 mcg (1 mg) once per week for four weeks, followed by 1000 mcg once per month" given intramuscular or deep subcutaneous injection has been found to be the most effective treatment for pernicious anemia. Need Professional Help?