An ironic "in joke" among hematologists goes something like this: "Look at the sales of vitamin B12! We must be missing a lot of PA." In truth, there isn't much pernicious anemia in the country, but there is a lot of B12 in American deltoid and gluteus.
VITAMIN B12 is essential for cell multiplication and for normal function of the nervous system.1-3 Symptoms of its deficiency may be vague and include fatigue, irritability, paresthesias, and problems with mentation. Although there may not be anemia, it is usually present, macrocytic, and sometimes severe. Subclinical nutritional deficiency is believed by many to be common and often nonspecifically symptomatic. In some cases, this may be true (eg, iron deficiency in the menstruating female). Consequently, it is not surprising that cyanocobalamin ("B12") shots are frequently administered to patients who are vaguely ill, worried but well, or merely desirous of
McCurdy PR. "B12 Shots". JAMA. 1974;229(6):703–704. doi:10.1001/jama.1974.03230440061041
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