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Adverse reactions after a B12 injection may include: A feeling of tightness in the chest Anaphylaxis (difficulty breathing or swallowing) Chest pain Congestive heart failure Heart palpitations Pulmonary edema Rapid heartbeat (tachycardia) Shortness of breath Vascular thrombosis Musculoskeletal Effects Your musculoskeletal system makes up your bones, tendons, cartilage, and connective tissues

The most useful monitoring plan is individualized

3 ml Syringe : Useful for administering larger doses in a single injection, minimizing the need for multiple injections, which can be more comfortable for the patient

Advantages of oral form over IM injection: Less nursing time on injections Less complexity of care Less discomfort/pain Less bleeding in patients who take anticoagulants Less costly according to some analyses Disadvantages of oral form over IM injection:: Greater risk of non-compliance In 1991, a survey done on Minneapolis internists led one commentary to conclude that oral vitamin B 12 replacement for pernicious anemia was one of medicines best kept secret. 18 In 1996, when the survey was repeated again in the same area, awareness and use of oral vitamin B 12 for pernicious anemia had increased substantially (019%), but the majority of doctors still remain unaware of this treatment option (61%)

Regular injections ensure a steady supply of B12

A completers analysis uses data from a subset of participants who did not have their endpoint imputed in the primary analysis and can bypass the issue of missing data