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Reported side effects of corticosteroids include: Hydroelectrolytic disorders: sodium retention, potassium loss, hypokalemic alkalosis, fluid retention, congestive heart failure in susceptible patients, hypertension Musculoskeletal: muscle weakness, myopathy, loss of muscle mass, aggravation of myasthenic symptoms in myasthenia gravis, osteoporosis, vertebral compression fractures, aseptic necrosis of the head of the femur and humerus, pathologic fracture of long bones, tendon rupture Dermatological: impaired wound healing, atrophy and thinning of the skin, fragile skin, petechiae and ecchymoses, facial erythema, increased sweating, suppression of reactions to skin tests, allergic dermatitis, urticaria, and angioedema

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Potential Benefits of a Combined Approach (Under Medical Guidance) When managed by a healthcare professional, a combined approach of B12 injections and tablets might offer several advantages for specific individuals: Potentially Less Frequent Injections: For those who find injections inconvenient or uncomfortable, a combined regimen could mean fewer trips to the clinic for jabs, improving quality of life

Ehlers, H., & Pelkner, M