Evidence-based management of anti-arrhythmic medications in the emergency department
Vitamin B12 can be injected just under the skin, or directly into the muscle
High expression of nicotinamide N-methyltransferase in patients with obesity and insulin resistance
Weight regain after discontinuation is nearly universal without sustained lifestyle changes
You should contact your GP if: You have been found to have elevated B12 levels on blood tests, particularly if levels exceed 1000 ng/L (approximately 740 pmol/L, though laboratory reference ranges vary) and you are not taking high-dose supplements You develop new symptoms after starting B12 supplementation, including persistent skin rashes, significant gastrointestinal disturbance, or unexplained symptoms You have underlying liver disease, kidney problems, or blood disorders and are considering B12 supplementation You are taking B12 supplements without medical supervision and have not had your levels checked, particularly if taking doses exceeding 2000 micrograms daily You experience symptoms that might indicate underlying disease, such as unexplained weight loss, persistent fatigue, jaundice, or abdominal swelling Call 999 or go to A&E if you develop severe allergic reactions following B12 injections, including difficulty breathing, facial swelling, or widespread rash, as these may indicate anaphylaxis, though this is extremely rare
The following groups are at higher risk of vitamin B12 deficiency and may need vitamin B12 shots
