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Symptoms of vitamin B12 deficiency include: Anemia Intestinal disorders and weight loss Fatigue, weakness, lightheadedness Memory loss or confusion Depression or dementia Rapid heartbeat and respiration Mouth or tongue soreness or bleeding Excessive bruising 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

For vials or other pen brands, treat the fridge as mandatory and plan around it

methionine, one of the key ingredients, may aggravate metabolic acidosis and a compromised liver may be unable to properly metabolize the compounds

[9] Visual disturbances have been reported in patients with Leber hereditary optic neuropathy, and rapid B12 administration may precipitate optic nerve atrophy in this genetically predisposed population, mandating extreme caution or alternative therapy