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At 5mg/mL (10mg vial + 2mL water), a 4mg dose requires 80 units

If I understand rightly you haven't an absorption problem.So once on supplements or a richer B12 diet you can store and utilise b12 from your liver

This information is invaluable for your healthcare provider in determining whether symptoms are genuinely related to B12 supplementation or reflect an independent condition requiring separate investigation

There is supporting evidence reporting adverse effects from long-term rhIGF-1 treatment including neoplastic formation, cataract and renal hypertrophy, all of which seem to be the most severe effects observed and are usually rare [123, 282284]

funding received from the Wellcome Trust and the British Heart Foundation