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In the case of suspected cobalt hypersensitivity, an intradermal test dose should be administered because anaphylactic shock and death have followed parenteral administration of cyanocobalamin.

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Clinical Indications for Higher IV Dosages For very severe cases, like serious neurological problems, higher doses of IV vitamin B12 might be needed

Abhishek Pilani, MBBS MD Dermatology (Gold Medalist), ISHRS Member, and Founder of Assure Clinic, is direct on this point: "B12 deficiency causes a specific type of hair loss telogen effluvium
