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Allergy risk to cobalt or preservatives (rare) Energy improvement: 24-72 hours Reticulocyte response: 3-5 days Neurological improvement: Weeks to months Hematological normalization: 4-8 weeks Maximum nerve repair: Up to 1 year Injection site reactions (15-20%) Mild diarrhea (initial doses) Itching/eczema (cobalt sensitivity) Transient anxiety (overstimulation) Headache (usually resolves quickly) Serious reactions are extremely rare