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Figure 1: B 12 Test Result Review and Process Algorithm for Patients with Risk Factor for B 12 Deficiency* and/or Non-specific** or Specific Symptom of B 12 Deficiency TOP Management Treatment In suspected B 12 deficiency, supplement both B 12 and folate

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If you develop persistent lumps: Avoid injecting in that area until nodule resolves (often 3-6 months) Consider ultrasound imaging if large, painful, or growing Dermatology consultation may be warranted for biopsy if diagnosis uncertain Building Your Peptide Stack the Smart Way Most injection site problems stem from trying to do too much, and too fast