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Neurological symptoms often develop gradually and may include: Paraesthesia : tingling or 'pins and needles' sensations, typically starting in the feet and hands Numbness : reduced sensation in the extremities, which may affect balance and coordination Burning pain : particularly in the feet, often worse at night Weakness : muscle weakness and difficulty walking Balance problems : unsteady gait and increased fall risk due to proprioceptive impairment Cognitive changes : memory problems, confusion, difficulty concentrating, and mood disturbances Haematological signs may accompany neurological symptoms and include fatigue, weakness, pallor, and shortness of breath due to megaloblastic anaemia

Dosage for Nascobal The recommended initial dose of Nascobal (cyanocobalamin) Nasal Spray is one spray (500 mcg) administered in ONE nostril once weekly

You can read more about Tesamorelin therapy and how physician-guided treatment plans are developed

Medication Interference : Some drugs, such as metformin, used for the treatment of Diabetic patients, and Proton-pump inhibitors, which treat patients with Acid reflux, prevent B12 absorption