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Participants were initially split into an intervention group of combined 20 mg lidocaine and 1000 g B12 delivered locally by subcutaneous injection once a day whilst a control group received 1000 g B12 plus 20 mg lidocaine IM injection once a day

Next, we clean the injection site, typically the thigh, upper arm, or abdomen, with an alcohol wipe and allow it to dry completely to minimize irritation

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The remainder of the studies included in this systematic review were observational studies or non-randomised interventional studies, which inherently have a high risk of bias

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(GeneReviews/NCBI, updated descriptions)