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TNF- upregulates epithelial adhesion molecules, promotes inflammatory cell recruitment and activation, and induces inflammatory mediator release, resulting in tissue damage [98]

Some pharmacies use methylcobalamin instead of cyanocobalamin, which is a different form of B12 with slightly different pharmacokinetics

Nutrition and exercise remain essential alongside the medication to maintain metabolic rate and bone strength

Warning signs to look out for include: Sudden hives or raised, itchy welts on the skin Swelling of the face, lips, tongue or throat Wheezing, shortness of breath or chest tightness Dizziness, fainting or a feeling of pressure in the chest If you experience any of these symptoms stop using the injection immediately and seek urgent medical attention

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