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Early signs may include implantation spotting, mild cramping, breast tenderness, fatigue, and nausea, appearing about 12 weeks after ovulation

Banerjee, and T.A

As the affected area is quickly cooled down, the motor reflex loops that keep the muscles cramped and spastic are suppressed, relieving the muscle spasms

Recognising Symptoms of B12 Deficiency Beyond Tiredness While persistent tiredness is often the presenting complaint, vitamin B12 deficiency produces a constellation of symptoms affecting multiple body systems

Jun 2016;36(6):499-508

The decision comes down to where you are in your dosing protocol
