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An alcohol swab should be used to clean the injection site (usually your thigh, abdomen, or upper arm)

[16] Although cyanocobalamin lacks a defined upper-toxicity threshold due to its water solubility and renal elimination, exceptionally high cumulative doses have been temporally associated with acneiform eruptions, altered potassium homeostasis, and theoretical thrombotic risk, emphasizing the importance of evidence-based dosing

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When you are deficient, symptoms can include fatigue, weakness, and brain fog