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An endoscopy can see the upper GI tract but doesn't quantify bacterial populations

1,2,6 The resultant abnormal erythropoiesis can trigger other notable abnormal laboratory findings, such as decreased haptoglobin levels, high lactate dehydrogenase levels, and elevated reticulocyte count

According to MHRA product information for hydroxocobalamin (the standard injectable form used in the UK), common side effects include injection site reactions and occasional hypersensitivity reactions, but anxiety is not listed as a recognised adverse effect of B12 supplementation

Therefore, it is important to follow the manufacturers directions regarding the amount of bacteriostatic water needed for each specific product when reconstituting peptides