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Allergy risk to cobalt or preservatives (rare) Energy improvement: 24-72 hours Reticulocyte response: 3-5 days Neurological improvement: Weeks to months Hematological normalization: 4-8 weeks Maximum nerve repair: Up to 1 year Injection site reactions (15-20%) Mild diarrhea (initial doses) Itching/eczema (cobalt sensitivity) Transient anxiety (overstimulation) Headache (usually resolves quickly) Serious reactions are extremely rare

Owing to the complementary functions of vitamin B12 and folic acid it is difficult to obtain the health benefits of B12 alone

While not every child responds the same way to supplementation, the research shows that a trial of methyl B12 may be worth consideration.

You listen to your body

At week 16, patients who did not meet the American College of Rheumatology criteria for 20% improvement (ACR20) were switched from 15mg of oral MTX to 15mg of SC MTX and from 15mg of SC MTX to 20mg of SC MTX for the remaining 8 weeks, still in a blinded manner