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Advantages of oral form over IM injection: Less nursing time on injections Less complexity of care Less discomfort/pain Less bleeding in patients who take anticoagulants Less costly according to some analyses Disadvantages of oral form over IM injection:: Greater risk of non-compliance In 1991, a survey done on Minneapolis internists led one commentary to conclude that oral vitamin B 12 replacement for pernicious anemia was one of medicines best kept secret. 18 In 1996, when the survey was repeated again in the same area, awareness and use of oral vitamin B 12 for pernicious anemia had increased substantially (019%), but the majority of doctors still remain unaware of this treatment option (61%)

Vitamin B12 is essential for energy production and maintaining healthy nerve cells and red blood cells

symptom management and orthotic support AFO for foot drop (L-code orthoses), custom footwear, surgery for foot deformity (pes cavus correction) Genetic counseling: document gene mutation identified (PMP22 duplication CMT1A, GJB1 CMTX, MFN2 CMT2A) Avoid neurotoxic drugs (vincristine, colchicine) document CMT diagnosis prominently in medication reconciliation Patient Education / Summary Patient education documentation supports coding specificity and demonstrates active management of neuropathy complications

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