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This occurs in conditions such as pernicious anemia, an autoimmune condition that affects the production of intrinsic factor, which is necessary for the absorption of B12 in the small intestine

Call Your Provider Promptly For Severe abdominal pain (possible pancreatitis) Persistent vomiting that prevents fluid intake Right-upper-quadrant pain that radiates to the back or shoulder (possible gallbladder issue) Sudden vision changes (rare, but reported) Symptoms of severe dehydration: dizziness on standing, dark urine, dry mouth For a deeper dive on what to expect over time, our side effect timeline guide walks through duration and management for each common issue

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Methylcobalamin and hydroxocobalamin are generally preferred over cyanocobalamin for athletes due to better retention and utilization