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When joint discomfort occurs after starting B12, it is typically coincidental or related to other factors such as excipients in formulations, injection-site effects, pre-existing musculoskeletal conditions, or rare hypersensitivity reactions rather than a direct effect of the vitamin itself

While risk is poorly characterized in smaller racial and ethnic groups in the U.S., multiple studies have reported differences in risk among Hispanic, nonHispanic Black and nonHispanic White individuals