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How to Use: Typical dosage is to inject 1 mL into the muscle or under the skin once per month Use a clean needle and syringe for each injection Follow your healthcare providers directions closely Warnings: Not for individuals with hypersensitivity to cobalt or vitamin B12 Use with caution in patients with Lebers disease or other optic nerve disorders In rare cases, high doses may lead to low potassium levels or allergic reactions

Vaishnava et al., 2008

Shared decisionmaking is emphasized: physicians explain benefits, risks, and alternatives, allowing women to choose the path that best fits their lives and values

Unfortunately, many patients delay care until symptoms are severe, such as persistent hoarseness, difficulty swallowing, or unexplained weight loss

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