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Known Side Effects Reported side effects are generally mild and infrequent: Injection site reactions: temporary redness, mild swelling, or tenderness Nausea: occasionally reported, usually mild and transient Dizziness: rare, typically with first doses Fatigue: some users report temporary tiredness Headache: infrequent, usually resolves quickly These effects typically diminish with continued use and rarely require treatment discontinuation

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Monitoring and follow-up Monitor clinically and repeat tests as indicated by the underlying condition Ongoing monitoring of liver function, renal function, and FBC as clinically indicated Regular review in primary care or specialist clinics for underlying conditions Patient advice: Patients should understand that elevated B12 is a marker requiring investigation rather than a condition requiring direct treatment