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Clinical practice guidelines suggest several scenarios where dose modification may be appropriate: Persistent gastrointestinal symptoms lasting beyond the first week of a new dose level may warrant extending that dose phase by an additional 2-4 weeks before further escalation

Methyl B12 is the most promising treatment for patients with severe neurological symptoms, bypassing several steps in the absorption cycle and helping to relieve or completely reverse symptoms

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Common side effects may include: Mild injection-site reactions (redness, soreness, itching) Upset stomach or nausea Headache Mild anxiety or restlessness Rarely, allergic reactions If you experience difficulty breathing, severe dizziness, or hives, seek medical attention immediately

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