Always confirm against your own vial, diluent, and clinician or pharmacy instructions
For example, a B 12 -deficient state which causes megaloblastic anemia and which may be mistaken for classical PA may be caused by infection with the tapeworm Diphyllobothrium latum , possibly due to the parasite's competition with host for vitamin B 12
Also, people with diabetes who take a medication called metformin are at a higher risk of developing B12 deficiency because this medication can reduce B12 absorption
Remember that wellness is a journey, not a destination
Common reactions may include pain, redness, or irritation at the injection site, mild diarrhea, nausea, itching, headache, dizziness, or a general feeling of swelling