Many people, especially those with dietary restrictions or certain health conditions, may have difficulty absorbing sufficient B12 from food alone
Signs and symptoms of vitamin B12 deficiency can include fatigue, pale skin, headaches, shortness of breath, fast heartbeat, gastrointestinal issues, mouth inflammation, paresthesias (abnormal sensations), decreased cognitive ability, depression, muscle weakness, imbalance and incoordination, vision problems, and erectile dysfunction
This means your medication came lyophilized and needs to be mixed
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A reasonable titration schedule might look like this: Week 1: 200mcg once daily Week 2: 300mcg once daily Week 3 onward: 300-500mcg based on response and tolerance Optimizing injection technique Poor injection technique contributes to injection site reactions and potentially to other effects like nausea from anxiety around the process