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theoretical risks include increased hypoglycaemia, unpredictable cardiovascular effects, and compounded uncertainty from two incompletely characterised compounds

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Similarly, corticosteroids should be used with great caution in patients with Strongyloides hyperinfection and dissemination with widespread larval migration, often accompanied by severe enterocolitis and potentially fatal Gram- sepsis

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Joint pain developing after starting B12 may reflect: Pre-existing musculoskeletal conditions becoming more noticeable Concurrent inflammatory or degenerative joint disease Reactions to excipients in certain formulations The natural course of an underlying condition If you experience persistent or worsening joint symptoms after beginning B12 supplementation, it is advisable to consult your GP or healthcare provider