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You should contact your GP or NHS 111 if you experience: Persistent diarrhoea lasting more than 7 days in otherwise healthy adults Blood or mucus in stools , which may indicate inflammatory bowel disease or infection Severe abdominal pain or cramping that is worsening or different from previous digestive symptoms Unexplained weight loss alongside bowel changes Signs of allergic reaction , including rash, itching, swelling, or difficulty breathing (call 999 or go to A&E for severe reactions) Neurological symptoms such as numbness, tingling, balance problems, or memory difficulties, which may indicate B12 deficiency is not being adequately treated Seek help sooner if you have red flag symptoms, are pregnant, immunosuppressed, elderly, or have significant underlying health conditions

For others, it might take a few weeks of consistent injections before you notice a change if your symptoms are more complicated, such as numbness, exhaustion, or memory problems

(9) Holotranscobalamin, the active fraction, estimates the B12 actually available to cells