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The standard practice is to use the same syringe to draw both compounds

modern care typically uses lidocaine

Biotin is involved in metabolic processes related to the utilization of fats, carbohydrates, and amino acids, while also influencing cell growth and blood sugar levels

Other common reasons are a local injection-site reaction, your body adjusting to corrected levels, and an underlying deficiency that was more severe than expected

There are also certain drugs and health conditions that can increase the likelihood of developing a B12 deficiency such as: alcohol abuse, antacid use, smoking, celiac disease, other digestive concerns, pregnancy, a strict vegetarian or vegan diet, and even natural aging