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[34] Neurological symptoms: sensory or motor deficiencies (absent reflexes, diminished vibration or soft touch sensation) and subacute combined degeneration of the spinal cord

S7)):107114

High doses of Vitamin C taken within 1 hour of the shot may lower B12 in blood (minor, stagger doses)

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[13] Chloramphenicol has been shown to blunt reticulocyte response to cyanocobalamin, while ethanol, colchicine, and nitrous oxide interfere with cobalamin metabolism or utilization, each warranting clinician awareness when evaluating suboptimal treatment outcomes

12 mg subcutaneous daily , or 1 mg three times weekly , is the most commonly used GHK-Cu skin dose in published research and clinic practice