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While often temporary, this increase in platelets carries serious risks: Deep vein thrombosis (blood clots in deep veins, usually in legs) Pulmonary embolism (blood clots in lungs) Arterial thrombosis (clots in arteries) Cerebrovascular events (strokes) Coronary artery thrombosis (heart attacks) Splanchnic vein thrombosis (clots in abdominal veins) The risk is particularly high in: Elderly patients Those with pre-existing heart disease Patients with inherited blood-clotting disorders Immobilized individuals Those with hardened arteries Neurological Symptoms and Joint Pain Paradoxically, B12 replacement can temporarily worsen or trigger new neurological symptoms

How soon can I expect to see results

I take a global view and want this number to be right at the top end of your range

It may be worth trying high dose oral/sublinguals in between injections - they can be effective for some patients - even those with PA - but don't help everyone