Each hour at room temperature is documented to reduce potency
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If palpitations persist beyond 3-4 days or are accompanied by chest tightness or dyspnea, discontinue and seek medical evaluation
Most injection site reactions resolve within 24-48 hours
Chandy thinks the phenomenon occurs because the B12 allows the body to put itself right, and if you have had things wrong for a long time, then theres a lot to put right in a small period of time
Dutton LC, Paszkiewicz KH, Silverman RJ, Splatt PR, Shaw S, Nobbs AH, et al