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Patients should be reassured that injection site lumps, whilst inconvenient, are generally not serious and can be effectively prevented with proper technique and site rotation

chronic liver disease and hepatitis may present with elevated levels Renal impairment : Reduced clearance can contribute to accumulation, though this is rarely clinically significant Solid tumours : Certain malignancies, particularly hepatocellular carcinoma and metastatic disease, may elevate B12 levels [3] Evidence suggests that unexplained markedly elevated B12 levels without supplementation may sometimes be associated with underlying disease

White J, Podesta A, Dyess GA et al

It is a synthetic peptide - a short chain of 15 amino acids - that was originally derived from a protein found in human gastric juice

Anything with a pH below 7 is an acid, and anything with a pH above 7 is an alkali, or base