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Others might observe that the effects begin to lessen

[5] The primary contraindication for hydroxocobalamin injection is a known hypersensitivity to hydroxocobalamin, cobalt, or any component of the formulation

Kassem HS, Sangar V, Cowan R, Clarke N, Margison GP (2002) A potential role of heat shock proteins and nicotinamide N-methyl transferase in predicting response to radiation in bladder cancer

That said, alcohol can impair judgment about injection technique, interfere with sleep and recovery, add empty calories that work against fat loss goals, and contribute to dehydration that may worsen side effects like headaches

Larger, longer clinical trials are needed to confirm long term effects

Mild nausea: Some patients experience brief nausea after their injection