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Possible Side Effects or Concerns Nausea, diarrhea, headache, or an unpleasant taste Acneiform or rosacea-like eruptions reported in some people using high doses Allergic reaction to cobalt, B12, flavoring, dye, preservative, or another ingredient Incorrect dosing caused by confusing drops, droppers, milliliters, and micrograms Delayed diagnosis when fatigue or neurologic symptoms are assumed to be just low B12 Misinterpretation of a high blood B12 level after supplementation Medicine and Health Considerations Metformin and gastric acid inhibitors can lower B12 status over time

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Nature 583 , 441446 (2020)