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some experience a mild flu-like reaction (joint aches, low-grade fever) for 2448 hours after, which is benign and self-limiting

CMS Transmittal 13673 (CR 14392) updated the MPFSDB effective April 6, 2026

In some rare cases, very high levels of B12 in the blood can be associated with minor side effects like mild acne, dizziness, or a temporary rash

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This granular control helps some users manage side effects more effectively

B12 injections: as this option delivers the nutrient directly into the bloodstream bypassing the area of the stomach unable to absorb it, it may be a good option for bariatric surgery patients who underwent gastric bypass to prevent a vitamin B12 deficiency