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Get up slowly from a sitting or lying position to avoid dizziness

In these instances, it is at the discretion of the prescriber as to whether cyanocobalamin is prescribed on a FP10 prescription

Neurological symptoms often develop gradually and may include: Paraesthesia : tingling or 'pins and needles' sensations, typically starting in the feet and hands Numbness : reduced sensation in the extremities, which may affect balance and coordination Burning pain : particularly in the feet, often worse at night Weakness : muscle weakness and difficulty walking Balance problems : unsteady gait and increased fall risk due to proprioceptive impairment Cognitive changes : memory problems, confusion, difficulty concentrating, and mood disturbances Haematological signs may accompany neurological symptoms and include fatigue, weakness, pallor, and shortness of breath due to megaloblastic anaemia

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Third, monitoring burden where more compounds mean more lab markers to track and more potential variables if something changes