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The physician should provide information to the patient about the signs and symptoms of hepatotoxiciy that should cause alarm (e.g., nausea, fatigue, lethargy, pruritus, jaundice, right upper quadrant tenderness and "flu-like" symptoms)

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The pattern is clear: every step up the dose ladder brings a fresh wave of GI symptoms

O., Zagarins, S

10.1002/jcb.29240 81 YoboueE

While some patients are able to get enough B12 through their consumption of red meats, dairy products, and fish, other patients find their dietary restrictions or metabolism limit the amount of B12 they receive