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Funding The author(s) declared that financial support was not received for this work and/or its publication

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COPD is a chronic disease characterized by chronic airway inflammation, airway remodelling, airflow obstruction, and loss of the alveolar parenchyma

Injections are the most effective means of administration of vitamin B12 since they do not depend on the body's ability to absorb the substance through the gastrointestinal tract

Titration: There is generally no need for upward titration with B-complex vitamins as one might do with certain drugs, but if a patient is frail or known to react to injections, the provider may choose to start at a lower dose (for example 0.25-0.5 mL) and then increase to 1 mL as tolerated