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Cheeran MC, Lokensgard JR, Schleiss MR

When starting Vitamin B12 therapy, its not unusual for individuals to grapple with questions like, Feeling worse after my B12 injection, is that natural? This period, often termed as a healing crisis, can manifest through symptoms such as: Enhanced feelings of fatigue, tiredness, and increased sleep requirements Sensations akin to mild flu-like symptoms or body aches Experiences of headaches, nausea, or feelings of being lightheaded A foggy mind and challenges with concentration Mood fluctuations including irritability, anxiety, or a subdued mood Alterations in appetite and digestive patterns Contrary to being seen as an adverse reaction, these symptoms are essentially indicative of the body acknowledging and adapting to the surge of B12

Include complex carbohydrates for consistent energy, such as brown rice, oats, and quinoa

There are also rarer risks

For patients with severe obesity (BMI 40 kg/m or 35 kg/m with comorbidities) who have not achieved adequate weight loss with non-surgical interventions, bariatric surgery may be considered following specialist assessment, as outlined in NICE CG189