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If youre unable to pull the syringe plunger back (the syringe does not fill with blood) then proceed with pushing the plunger down slowly over 5 to 10 seconds

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Long-term use of metformin and its effect on serum vitamin B12 with its oral manifestations: a review

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Some individuals may experience an increase in symptoms like headaches or lethargy shortly after a B12 injection, this effect should be temporary and followed by symptom improvement

Strict vegetarians, vegans or people with an unbalanced diet can also expect vitamin B12 deficiency