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The response is cumulative, building across the 4 doses and continuing into the weeks after the final injection

This comprehensive training course is designed for eligible practitioners wishing to learn the knowledge and practical skills required to provide vitamin injection treatments safely and professionally

After injecting, keep the needle in place for about 10 seconds before withdrawing

For rubber-stoppered vials that have been punctured, consider transferring remaining peptide to fresh, sealed containers

There are other alternative forms for B-12 administration which includes monthly intramuscular injection, sublingual (under the tongue) liquids or sprays, or nasal spray which more adequately enable absorption. (Source) The current ASMBS recommendations for VSG (which are summarized here) list a B-complex vitamin (which includes B-12) as optional but doesnt elaborate on how it should be taken

There may also be no symptoms of a meniscus tear after the initial injury