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Side effects from B12 supplementation are uncommon but may include: Mild gastrointestinal symptoms such as nausea or diarrhoea, typically with very high oral doses Headache or dizziness in some individuals Skin reactions (rash, itching) at injection sites when using intramuscular preparations Rare but serious allergic reactions, including anaphylaxis with injectable forms Hypokalaemia (low potassium) may occur during rapid correction of severe megaloblastic anaemia If you experience symptoms of a severe allergic reaction (difficulty breathing, severe rash, swelling of face or throat) after taking B12, seek immediate medical attention

When levels are high or symptoms like confusion, breathing problems, or loss of consciousness appear

Cognitive and mood effects build over the first 2 weeks of consistent dosing as cellular NAD+ stores rebuild

Science, 2004