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Serious complications, while rare, may include spinal cord damage, dural puncture, and/or stroke

Reduced fatigue

When nerves are compressed, they cannot transmit signals related to movement and sensation to the brain

However, conditions affecting the gastrointestinal tractincluding pernicious anaemia, Crohn's disease, coeliac disease, or gastric surgerycan significantly impair absorption, necessitating alternative supplementation routes such as intramuscular hydroxocobalamin injections, which deliver B12 directly into the bloodstream

Average fat mass reduction across reviewed trials was under 1% compared to lifestyle advice alone