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These observations help identify the actual source

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The most common B12/MIC side effect is pain, redness, or itching at the injection site

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A reasonable titration schedule might look like this: Week 1: 200mcg once daily Week 2: 300mcg once daily Week 3 onward: 300-500mcg based on response and tolerance Optimizing injection technique Poor injection technique contributes to injection site reactions and potentially to other effects like nausea from anxiety around the process