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Contact your GP if you experience: Unexpected symptoms after starting B12 supplementation, including persistent skin reactions, gastrointestinal disturbance, or mild allergic manifestations Neurological symptoms such as significant tingling, numbness, weakness, or balance problemsthese may indicate B12 deficiency paradoxically, or alternative neurological conditions requiring assessment Unexplained fatigue or malaise that develops or worsens despite supplementation Concerns about medication interactions , particularly if taking metformin, proton pump inhibitors, or other medications affecting B12 metabolism [2] [4] Seek emergency medical attention (call 999) if you develop signs of a severe allergic reaction following B12 injection, including facial swelling, difficulty breathing, or widespread urticaria

Prepare for your consultation by: Documenting your current rheumatoid arthritis symptoms, disease activity, and treatment history Listing all current medications, including DMARDs, biologics, corticosteroids, and analgesics Noting any comorbidities, particularly diabetes, obesity, cardiovascular disease, or gastrointestinal conditions Being honest about your treatment goals and what has prompted interest in GLP-1 therapy Questions to discuss with your doctor : What is the current evidence for GLP-1 use in rheumatoid arthritis