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They should also be instructed about signs and symptoms that warrant dose adjustment or medical evaluation, including severe gastrointestinal side effects or other unusual symptoms that may indicate adverse reactions, as determined relevant by the prescribing clinician

One proposed hypothesis, as yet untested, is that high-dose folic acid supplements cause depletion of the transport protein holotranscobalamin in serum, thus exacerbating B12 deficiency

Kainat A, Phang CR, Ain NU, Agarwal B

The congestion is clearing

The ideal approach: order your next vial when you have approximately 7 to 10 days of medication remaining