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Neurological symptoms often develop gradually and may include: Paraesthesia : tingling or 'pins and needles' sensations, typically starting in the feet and hands Numbness : reduced sensation in the extremities, which may affect balance and coordination Burning pain : particularly in the feet, often worse at night Weakness : muscle weakness and difficulty walking Balance problems : unsteady gait and increased fall risk due to proprioceptive impairment Cognitive changes : memory problems, confusion, difficulty concentrating, and mood disturbances Haematological signs may accompany neurological symptoms and include fatigue, weakness, pallor, and shortness of breath due to megaloblastic anaemia

Clinicians and their patients may want to know the potential effect on weight loss when fully adhering to the treatment, i.e., the extent of the pharmacological effect

Side Effects B12 injections are generally safe and well-tolerated

Kojima, Masayasu, Hosoda, Hiroshi, Date, Yasuhiko, Nakazato, Mitsunobu, Matsuo, Hiroaki, and Kangawa, Ken