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Serious reactions are extremely rare

These conditions digestive conditions, such as Crohns disease and ulcerative colitis autoimmune conditions, such as celiac disease and type 1 diabetes genetic conditions, such as inherited intrinsic factor deficiency and inherited transcobalamin deficiency chronic pancreatic disease pernicious anemia vitiligo Other factors that may lead to a vitamin B12 deficiency can include drinking excessive amounts of alcohol or using certain drugs, such as some heartburn medicines and metformin

"Research use only" products are not approved for human use

They can create a Popeye-like bulge in the upper arm

In 2003, a Cochrane review of three RCTs on cognitive function in patients with AD or other forms of cognitive impairment also found no evidence of benefits of B12 on cognitive function compared with placebo

, and this route of absorption is unaffected in patients with pernicious anemia