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Patients with pernicious anemia or others who cannot absorb B from food typically need lifelong B therapy, often on a monthly injection schedule

The most common side effect of B12 injections is irritation at the injection site, and injections are typically administered intramuscularly or subcutaneously. Less common side effects may include headache, nausea, diarrhea, itching, or a brief feeling of lightheadedness after the injection

Some users compare bacteriostatic water with sterile water alternatives

Since B12 plays a role in energy metabolism, some people report feeling more alert after taking their supplement, though this effect is anecdotal and not scientifically established