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A meta-analysis of randomized, controlled trials demonstrated an approximately 2-fold increase in hospitalizations for heart failure among non-selective and COX-2 selective-treated patients compared to placebo (5)

While the NIH does not specify a tolerable upper intake level for vitamin B12, a study published in the JAMA Network Open found that high intakes of vitamin B12, such as from daily supplementation of 25 micrograms or higher, increased the risk of bone fracture [3] [4]