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Brian Heeringa Dr

or p.o., alongside local lidocaine, and found the local B12 injection to be significantly more effective in pain relief than either i.m

Injection site reactions : Localised redness, swelling, or discomfort at the injection site

P 4 lines of therapy, including an immunomodulatory drug, proteosome inhibitor, and anti-CD38 monoclonal antibody

There are no major side effects reported, though patients can experience diarrhea and swelling or redness at the injection site

Higher-dose oral B12 (e.g., 1000 g daily) is sometimes used but should only be considered under clinical supervision with appropriate monitoring, particularly in cases of malabsorption where intramuscular treatment remains the first-line approach in UK practice