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I havent been professionally checked, but my resting heart rate and ekg from my apple watch have been normal

Except for covid arm all other side effects have resolved

J Neurol Sci 156:6572 Al-Sarraj S, King A, Cleveland M et al (2014) Mitochondrial abnormalities and low grade inflammation are present in the skeletal muscle of a minority of patients with amyotrophic lateral sclerosis

Just penetrate into the fat (we all have some) below your skin so that your body can absorb the vitamin B12 and you will begin to quickly feel its benefits over the next 24hrs