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Green et al 26 Severe clinical abnormalities should be treated intensively with B 12 , cyanoB 12 or hydroxyB 12 : HydroxyB 12 is commonly used in Europe, often at intervals of 23 months, as it seems to have better retention than cyanoB 12

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Vitamin B12 shot side effects Most people tolerate vitamin B12 injections well, but possible side effects include: Mild: soreness or redness at injection site, mild diarrhea, nausea, headache, itching Rare but serious: allergic reactions (rash, swelling, difficulty breathing), low potassium (hypokalemia), dizziness or heart rate changes Get emergency medical help if you have signs of an allergic reaction to Vitamin B12: hives

That process is slow, and for some people it is not very efficient