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When joint discomfort occurs after starting B12, it is typically coincidental or related to other factors such as excipients in formulations, injection-site effects, pre-existing musculoskeletal conditions, or rare hypersensitivity reactions rather than a direct effect of the vitamin itself

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Injections may be given to people who have malabsorption issues due to disorders such as Crohn's disease, atrophic gastritis, chronic pancreatitis, and intestinal bacterial overgrowth

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You need bloodwork before starting and monitoring throughout treatment