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Injecting too fast can create a bolus of medication that triggers a stronger local reaction

Be sure to inform your provider about any medications, supplements, or health conditions you have, especially if you are managing anemia or other blood-related concerns

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Conflict of interest Author TS reports that he provides strategic and scientific recommendations as a member of the Advisory Board and speaker for Novocure, Inc

Try 8 weekly

Additional risk factors include: Chronic kidney disease : Reduced renal clearance may impair B12 excretion Liver disease : Hepatic dysfunction can disrupt B12 metabolism and storage Myeloproliferative disorders : Certain blood cancers increase B12-binding proteins Concurrent medication use : Some drugs may interact with B12 metabolism, including metformin, proton pump inhibitors, and H2 antagonists Patients with these conditions should have B12 supplementation carefully monitored by their healthcare team