You should contact your GP if: You have been found to have elevated B12 levels on blood tests, particularly if levels exceed 1000 ng/L (approximately 740 pmol/L, though laboratory reference ranges vary) and you are not taking high-dose supplements You develop new symptoms after starting B12 supplementation, including persistent skin rashes, significant gastrointestinal disturbance, or unexplained symptoms You have underlying liver disease, kidney problems, or blood disorders and are considering B12 supplementation You are taking B12 supplements without medical supervision and have not had your levels checked, particularly if taking doses exceeding 2000 micrograms daily You experience symptoms that might indicate underlying disease, such as unexplained weight loss, persistent fatigue, jaundice, or abdominal swelling Call 999 or go to A&E if you develop severe allergic reactions following B12 injections, including difficulty breathing, facial swelling, or widespread rash, as these may indicate anaphylaxis, though this is extremely rare
If you are traveling for more than a few days, consider whether it makes more sense to bring lyophilized powder and reconstitute at your destination rather than trying to maintain a cold chain for reconstituted solution
Serious symptoms such as allergic reactions or irregular heartbeat require immediate care
After that point, the peptide structure begins degrading, and you might notice reduced appetite suppression or slower weight loss even though you are taking the same dose
