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Local tingling or pain is common before the blisters appear

in Frontiers in Pharmacology (2019) investigated the use of high-dose B12 nasal drops in 51 ME/CFS patients over 3 months

therefore, patients older than 50 years and vegans or strict vegetarians should consume foods fortified with vitamin B 12 or take vitamin B 12 supplements

Long-term vegans are a special case, because B12 is one nutrient a plant diet cannot reliably supply

WADAs prohibited list includes substances that enhance metabolic efficiency or cellular energy production in ways that confer performance advantage. World Anti-Doping Agency Potential Bans in Competitive Sports If you are a tested athlete, always consult your sports governing body