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This paradoxical reaction is not fully understood but is thought to be related to individual metabolic responses

Research community sources commonly describe rotating injection sites (abdomen, outer thigh, back of upper arm) to lower the chance of local irritation

10.1007/s10620-008-0332-9 130 SkorjanecS.KokotA.DrmicD.RadicB.SeverM.KlicekR.et al (2015)

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It is essential, however, to consult your healthcare provider before starting B12 injections if you are already suffering from any medical conditions or concerns