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J Clin Pharm Ther 2003;28:28994

While often temporary, this increase in platelets carries serious risks: Deep vein thrombosis (blood clots in deep veins, usually in legs) Pulmonary embolism (blood clots in lungs) Arterial thrombosis (clots in arteries) Cerebrovascular events (strokes) Coronary artery thrombosis (heart attacks) Splanchnic vein thrombosis (clots in abdominal veins) The risk is particularly high in: Elderly patients Those with pre-existing heart disease Patients with inherited blood-clotting disorders Immobilized individuals Those with hardened arteries Neurological Symptoms and Joint Pain Paradoxically, B12 replacement can temporarily worsen or trigger new neurological symptoms