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For people with normal B12, any weight change is usually small, inconsistent, and behaviorally driven (more activity, better appetite) rather than a direct effect of the vitamin

For patients receiving B12 replacement therapy for pernicious anaemia or deficiency , monitoring is typically arranged by the prescribing clinician

For most patients on standard one- to three-month cycles, this situation should not arise if ordering is timed appropriately to protocol length

Safety animal and some human data profiles generally look good, but clinical fertility trials are sparse

patients may notice persistent tiredness disproportionate to their activity level