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There is After having a B12 shot, a person should monitor for adverse symptoms and seek medical help if they experience: severe pain at the injection site mild diarrhea a swelling sensation in the body temporary itching of the skin In rare cases, a person may also be at risk of: anaphylaxis pulmonary edema congestive heart failure peripheral vascular thrombosis, which involves blood clots polycythemia vera, which is a type of blood cancer If anyone experiences difficulty breathing, hives, or swelling, they need emergency medical help

This is not a formal ceiling because no FDA-approved limit exists, but it represents the upper range of what is supported by preclinical scaling and provider experience

Gastrointestinal pathology, dysfunction, or surgery, including gluten enteropathy or sprue, small bowel bacterial overgrowth, total or partial gastrectomy

Wharton et al., Lancet Diabetes Endocrinol

Vitamin B3 (niacin) is involved in the citric acid cycle, in acetyl-CoA formation, and its coenzyme transitions from NAD+ to NADH