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Common reasons include: Digestive conditions Certain medications Dietary restrictions (e.g
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Patients who notice no effect by day 7 are unlikely to benefit from continued injections without addressing other metabolic factors
Without treatment, this leads to megaloblastic anaemia and potentially serious neurological complications
When B12 levels become problematic: High-dose supplementation (particularly doses exceeding 1,000 micrograms daily) Frequent B12 injections without medical supervision Underlying conditions affecting B12 metabolism Concurrent use of multiple B12-containing supplements The NHS does not set an upper safe limit for vitamin B12 because harmful effects from excessive intake have not been definitively established
