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Key published studies Pickart L, Margolina A

Intramuscular injection might occur if the needle is too long for the patient's body habitus or if the injection technique is incorrect

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Without adequate intake of B12, vegans can easily develop deficiency over time, leading to symptoms such as fatigue, weakness, constipation, loss of appetite, weight loss, and nerve problems therefore the researchers recommend that vegans and vegetarians should add vitamin B12 to their diet by eating fermented foods, particular types of mushroom that contain the vitamin and B12-enriched vegetables

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This leads to a gradual loss of vision, which can develop from visual disturbances such as spots and fogginess, to an almost complete loss of sight