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Id say two big take-homes from me, kind of wrapping it up here

However, this same mechanism is responsible for nausea, bloating, vomiting, and early satiety, especially when the body has not yet adapted to the drug

The British National Formulary (BNF), for example, differentiates the prescription of hydroxocobalamin according to presenting symptoms, eg, For neurological involvement, it is advised to administer hydroxocobalamin by intramuscular injection, initially 1 mg once daily on alternate days until no further improvement, then 1 mg every 2 months. In the Netherlands, pharmacotherapeutic guidelines51 recommend (for the same neurological symptoms or abnormalities) administration of 1000 mcg once or twice weekly for up to two years

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