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Seek urgent same-day assessment or call 999 for emergency care if experiencing: Severe chest pain Severe shortness of breath Fainting or collapse Acute or rapidly worsening neurological deficits (such as new limb weakness, sudden gait disturbance, or bladder/bowel dysfunction) Persistent or worsening anaemia symptoms despite treatmentincluding breathlessness, chest discomfort, palpitations, or extreme fatigueshould trigger medical review

The type of B12 supplement might matter too

This is due to the possibility that more glycine and serine may be needed to properly catabolize the extra methionine, unintentionally leading to a shortage in these amino acids

The acid-labile subunit of human ternary insulin-like growth factor binding protein complex in serum: hepatosplanchnic release, diurnal variation, circulating concentrations in healthy subjects, and diagnostic use in patients with growth hormone deficiency