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Typical symptoms of vitamin B12 deficiency The impaired blood formation with anemia causes fatigue, weakness, lack of energy and, in severe cases, pallor, rapid pulse, shortness of breath and dizziness

176 It noted that whilst formularies identify vitamin B 12 deficiency as a possible side effect of metformin, there is a lack of guidance relating to the investigation of the risk, despite there being a deficiency prevalence of 17% in the study cited in the editorial

82,83 Patients may also experience paresthesia and allodynia, where non-painful stimuli are perceived as painful

For example, FDA labeling for cyanocobalamin injection includes contraindications (such as hypersensitivity) and important warnings (see the FDA prescribing information for cyanocobalamin injection )

Scheduling an appointment in a medical office allows for ongoing monitoring and adjustment of therapy for weight loss as health needs evolve