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As reported in a European qualitative study, patients frequently expressed frustration with allergen avoidance recommendations they could not feasibly implement, especially when their livelihoods depended on manual tasks [42]

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Common side effects include, but may not be limited to: pain or redness at the injection site mild diarrhea pruritus (itching) increased swelling joint pain dizziness headache nervousness or anxiety Serious side effects may include: allergic reactions peripheral vascular thrombosis hypokalemia (low potassium levels) pulmonary edema (fluid build-up around or in the lungs) thrombocytosis congestive heart failure There have been reports of anaphylactic shock and death after the parenteral administration of vitamin B12