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Human musculoskeletal evidence is sparse and rarely includes verified product composition, standardized exposure assessment, or perioperative endpoints relevant to TJA

Many are just expensive placebos

Which medicines can affect vitamin B12

Protocol duration Nasal spray protocols typically follow similar durations to injectable protocols

The primary concern for the FDA was the lack of large-scale, randomized controlled trials, which are the gold standard for new drug approval

Possible side effects include: Mild pain, redness, or swelling at the injection site Headache or dizziness (usually transient) Nausea (uncommon) Hypokalaemia (low potassium) during initial treatment, particularly in severely deficient patientsthis is rare but may require monitoring [1] [5] When to seek medical advice: Serious adverse reactions are extremely rare