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The concern is practical rather than safety-based: receptor desensitization, diminishing returns, and cost

If your notes are in mg, convert to mcg by multiplying by 1,000 before entering

If they have prominent occipital neuralgia , then I will give additional dosing over the correlating occipital nerves (I do this very commonly is most patients I treat)

Please report these side effects immediately to your providerespecially if it is your first time receiving B12 injections

For patients with impaired folic acid absorption, intramuscular folic acid injection may be considered as an alternative to bypass gastrointestinal absorption

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