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The dose simply not working An incorrect dose, or one that mostly landed in fat, may mean your symptoms do not improve as expected

Generalized: Anaphylactic shock and death have been reported with administration of parenteral vitamin B 12(see WARNINGS)

If improvement plateaus or symptoms persist despite treatment, further investigation may be warranted to identify other contributing factors or alternative diagnoses

These may include mild digestive changes (nausea, altered bowel movements), increased energy levels that may feel stimulating initially, mild headaches (often related to dehydration), and minor injection site reactions (redness, temporary discomfort)