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Liver, kidney and allergic reactions have been reported with other forms (NOT methylcobalamin) of B12

One of the things they found was when B12 serum levels drop below 550 pg/mL, cerebrospinal fluid levels of vitamin B12 become low

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Given the rise in autoimmunity, side effects of multiple medications affecting this pathway and crashing levels of soil cobalt due to glyphosate this why this pathway is wrecked in so many people and why injection are needed by so many and often at high frequency.

Its bodybuilding relevance comes from tissue protection, repair, and recovery rather than direct anabolic stimulation

Standardized outcome measurement facilitates assessment of individual patient response and contributes to broader understanding of clinical efficacy