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Neurological symptoms often develop gradually and may include: Paraesthesia : tingling or 'pins and needles' sensations, typically starting in the feet and hands Numbness : reduced sensation in the extremities, which may affect balance and coordination Burning pain : particularly in the feet, often worse at night Weakness : muscle weakness and difficulty walking Balance problems : unsteady gait and increased fall risk due to proprioceptive impairment Cognitive changes : memory problems, confusion, difficulty concentrating, and mood disturbances Haematological signs may accompany neurological symptoms and include fatigue, weakness, pallor, and shortness of breath due to megaloblastic anaemia

Get up slowly from a sitting or lying position to avoid dizziness

If you only need to lose 10 to 15 pounds, a 12-week course of phentermine paired with solid lifestyle changes can get you there

If you take vitamin B6 supplements, do not take too much as this could be harmful

In these instances, it is at the discretion of the prescriber as to whether cyanocobalamin is prescribed on a FP10 prescription