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These may include: ( 4 ) Fatigue or lack of energy Brain fog or trouble concentrating Irritability or mood swings Pale skin or shortness of breath Tingling in the hands and feet Difficulty walking or staggering Anemia Swollen or inflamed tongue A B12 deficiency in men may also contribute to low testosterone, weight gain, and poor exercise recoverymaking it a hidden factor in many mens health concerns

Being nontoxic, sterile water does not cause fever or other issues when used either externally or as an injectable solution

Limitations of current studies When considering the limitations, not all studies used the same level of microscopic assessment, however, this is to be expected

Some have decades of clinical use behind them

Therefore, parenteral cyanocobalamin should be administered to a pregnant woman if the benefits outweigh the risks.[15][16] Cyanocobalamin is excreted in the breast milk of nursing women in levels similar to the level of vitamin B12 in maternal plasma.[25] The distributed cyanocobalamin in breast milk has been found to be compatible with breastfeeding by the American Academy of Pediatrics.[26] In addition, there has not been any reports of adverse effects associated with the intake of normal daily requirements of vitamin B12 during lactation