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This article explores the biological reasons for tiredness during treatment, from caloric deficits to metabolic shifts

However, some patients receiving high-dose B12 supplementation or injections may experience adverse reactions, though these relate to the treatment rather than the elevated levels: Possible reactions to B12 supplementation (particularly injections): Skin reactions, including acneiform eruptions or rashes Pruritus (itching) Injection site reactions (with parenteral administration) Rare hypersensitivity reactions Non-specific symptoms such as headaches, dizziness, or gastrointestinal disturbances have been reported by some patients taking B12 supplements, but causality is not well established in clinical evidence

some have shown slowed progression of diabetic kidney disease

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