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Your provider will set realistic expectations

Some improvement in symptoms may be seen within a few days to a week after starting treatment, but it can take longer for more severe symptoms to resolve

Pathological causes of elevated B12 warrant careful consideration: Haematological disorders : Myeloproliferative neoplasms (polycythaemia vera, chronic myeloid leukaemia), acute leukaemia, and lymphoproliferative disorders can increase B12-binding proteins (transcobalamin and haptocorrin), elevating total serum B12 [3] Liver disease : Hepatocellular damage releases stored B12 into circulation

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A fever accompanied by chills is particularly serious

Easy refill and quick delivery