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Houston Men use kayaks to get through an intersection after heavy rain from Hurricane Harvey flooded Pearland, in the outskirts of Houston, Texas, August 27, 2017

Injections are particularly appropriate for those with: Pernicious anaemia, an autoimmune condition affecting B12 absorption Conditions affecting the stomach or small intestine, such as Crohns disease or coeliac disease Those who have had gastric surgery or bariatric procedures Strict vegans and vegetarians not meeting their B12 needs through food or oral supplements For those who can absorb B12 normally, oral supplements are generally an effective and well-evidenced alternative to injections

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Medically, a muscle spasm is an involuntary, forceful muscle contraction that is sudden, potentially painful, and can temporarily impair muscle function