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Other medications, such as the antibiotic chloramphenicol or certain chemotherapy drugs, can also affect how your body processes vitamin B12

It also helps form red blood cells that carry oxygen throughout the body, which is why a deficiency can cause symptoms such as fatigue, weakness, and anemia

Avoid alcohol before the injection, as it can affect B12 absorption

When to increase dose Consider increasing if: Minimal response after 4-6 weeks at current dose No side effects at current dose Current dose below the higher end of recommended range Goals not being met with conservative approach Increase gradually, typically by 25-50% at a time