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[3] Hyperpigmentation is usually seen over the acral sites, especially dorsum of hands and feet, palms, soles, nails and oral cavity

B12 Side Effects in Elderly: Safety Guide for Older Adults Vitamin B12 supplementation is commonly prescribed for elderly patients, as deficiency becomes increasingly prevalent with age due to reduced gastric acid production, pernicious anaemia, and medication interactions

You're pregnant or plan on becoming pregnant while using B12 injections

Beyond direct costs, consider lost training time, potential race entry fees forfeited, and impact on athletic goals