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Common signs include: Persistent fatigue or low energy Brain fog or poor concentration Pale or yellowing skin Pins and needles or tingling sensations Low mood or irritability Muscle weakness Breathlessness Left untreated, a deficiency can lead to serious complications affecting your nervous system and long-term wellbeing

Because SIRVA results from incorrect injection technique, it is entirely preventable

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Patients should avoid ingesting large amounts of vitamin C within 1 hour of oral vitamin B12 administration Extended release potassium products Antibiotics such as gentamicin, neomycin, tobramycin Anti-seizure medications such as phenobarbital, phenytoin, primidone Medicines used to treat heartburn like H2 blockers such as cimetidine and proton pump inhibitors such as omeprazole Antacids such as ranitidine, cimetidine Vitamin B12 Injection Storage and Safety Information Vitamin B12 tablets should be in a cool and dry place