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Treating the underlying venous will not prevent the spider veins from ever coming back, but it will significantly slow their progression

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[18] Cyanocobalamin is the most common form used in dietary supplements and food fortification because cyanide stabilizes the molecule against degradation

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Common side effects include: Injection site reactions pain, redness, or swelling at the injection site Mild diarrhoea or gastrointestinal upset usually transient Skin reactions itching or rash (uncommon) Hypokalaemia rare, occurring when severe megaloblastic anaemia is corrected rapidly Serious adverse effects are extremely rare but may include anaphylaxis in hypersensitive individuals