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Red flags before your first shot: Known cobalt allergy or previous reaction to a B12 injection Family or personal history of Leber’s optic neuropathy Untreated polycythemia or unexplained high hematocrit Severe anemia with chest pain or breathlessness (that’s a supervised correction) Currently pregnant or breastfeeding (ask for preservative-free) On warfarin, a DOAC, or dual antiplatelet therapy Shots vs Oral B12: Which Has the Better Side Effect Profile