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A reasonable titration schedule might look like this: Week 1: 200mcg once daily Week 2: 300mcg once daily Week 3 onward: 300-500mcg based on response and tolerance Optimizing injection technique Poor injection technique contributes to injection site reactions and potentially to other effects like nausea from anxiety around the process

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For example: Proton pump inhibitors (PPIs) and H2 receptor antagonists, which are mainly used to reduce stomach acid, can affect the release of vitamin B12 from food and its absorption in the stomach

I am already down 6.5 pounds, it has really curbed my appetite Im eating less, drinking more water and excersising