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[1] This is to reduce the risk of hypotension or vein irritation

and a deletion of exon 4, were identified in compound heterozygous state

10.1016/j.semcdb.2011.05.005 [DOI] [PubMed] [Google Scholar] 24

Avoiding high-fat, greasy, or very spicy foods may also help minimize nausea and digestive discomfort

You may have a deficiency if you are vegan, dont eat enough B12 rich food, or if you have other health conditions which mean you are unable to absorb it properly