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Sings of vitamin B12 deficiency include the following: Megaloblastic anemia is a disorder with fewer red blood cells and larger than normal ones

2 hrs after reaching the maximum plasmatic concentration, the concentration of active drug is higher in the synovial fluid than in the plasma and the rest is reached in a period of 12 hrs

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Severe loss of quality of life, due to symptoms such as debilitating fatigue, insomnia (B12 is required for synthesis of melatonin), mental illness, and neurological symptoms

Since it does not affect hormone levels, insulin sensitivity, or appetite regulation, there is no rebound effect from discontinuation

Animal data covers relatively short treatment cycles, and extrapolating beyond that requires clinical judgment