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Hydroxocobalamin 1mg intramuscular injections reactivate metabolic pathways after chronic deficiency, potentially causing temporary symptoms during adjustment Common side effects include injection site pain, headaches, and nausea, typically resolving within 2472 hours Rapid red blood cell production may increase demand for folate and iron, occasionally creating relative deficiencies in these co-factors Serious reactions requiring urgent assessment include difficulty breathing, chest pain, severe weakness, or progressive neurological symptoms Recovery follows a predictable pattern: blood cell improvement within 35 days, haemoglobin normalisation over 12 months, neurological recovery potentially taking several months Table of Contents Why Do I Feel Worse After My B12 Injection

When the injection is performed in a hospital outpatient department (POS 22) or emergency department (POS 23) , the facility bills for the injection administration under OPPS, and the physician does not separately report procedure code 96372

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Endocrinology 136 , 49824989 (1995)

The presence of B12 deficiency itself may indicate an underlying digestive disorder that requires specific investigation and management