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Most people do not experience significant side effects from hydroxocobalamin
Most people tolerate B12 injections well
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Liver disease : liver enzyme monitoring is recommended in community use, and a baseline ALT/AST check is reasonable before starting
But chronic high-dose use may: Overstimulate metabolic pathways Alter methylation balance (since NNMT is tied to methyl donor cycling) Lead to unintended side effects like fatigue, irritability, or hormonal imbalance Stick to researched dosing windows (typically 1020 mg/day for short cycles in animal models) 2
