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Immunomodulation by vitamin B12: augmentation of CD8+ T lymphocytes and natural killer (NK) cell activity in vitamin B12-deficient patients by methyl-B12 treatment

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Hydroxocobalamin, the form most commonly used in the UK, may cause: Injection site reactions (pain, redness, or swelling) Temporary reddish discolouration of urine Rarely, hypersensitivity reactions Very rarely, hypokalaemia in severely deficient patients when treatment is initiated (potassium levels should be monitored in severe deficiency) B12 injections are considered very safe, with no upper tolerable limit established, as excess B12 is excreted in urine

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References 1 Nature Medicine (2014)Nicotinamide N-methyltransferase knockdown protects against diet-induced obesity (preclinical)