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The current findings also suggest that self-injection might be driven by poor perception of primary care safety and especially low-perceived dignity and respect

Conditions such as intestinal or stomach problems, poor nutrition, HIV, pregnancy, old age, veganism and alcoholism can contribute to vitamin B12 deficiency

Use aseptic technique to avoid contamination of the multidose vial

Many present with typical signs of B12 deficiency including ataxia, numbness and tingling in fingers and toes, confusion, weakness and depression

Vitamin B12 deficiency may cause numbness and tingling in the hands and feet, cognitive impairment, and reduced neurotransmitter production in the brain and spinal cord