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However, with direct injection, if you do not need the additional B12, it may result in high levels in your blood that can cause side effects including gastrointestinal issues, headache and dizziness, tiredness and weakness, or skin irritation until the excess is flushed out via your kidneys and urine

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NHS guidance describes an initial phase that can be every other day for 2 weeks (or until symptoms improve).Maintenance schedules are often every 23 months in appropriate long-term cases

Bhasin A, et al