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For example, additives such as carboxymethyl cellulose and mannitol can cause acute reactions

They act as cofactors for enzymes involved in metabolism, nutrient conversion, neurotransmitter production and cellular function

This depends on your personal situation, how low your vitamin B12 levels are intracellularly, what kind of medical conditions you have, and how much improvement you get from the B12 shots

PubMed Duzel, A., Vlainic, J., Antunovic, M., Malekinusic, D., Vrdoljak, B., Samara, M., Gojkovic, S., Krezic, I., Vidovic, T., Bilic, Z., Sjekavica, I., Djuzel, A.R., Knezevic, M., Sever, A.Z., Lojo, N., Kokot, A., Sever, M., Drmic, D., Seiwerth, S., & Sikiric, P

No staff intervention required