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People with neuromuscular diseases (like Lou Gehrigs disease, myasthenia gravis, or Lambert-Eaton syndrome) are at a higher risk of serious side effects

Within 48 hours after injection of 100 or 1000 mcg of vitamin B 12, 50 to 98% of the injected dose may appear in the urine

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The profound exhaustion, cognitive impairment often described as "brain fog," and unpredictable crashes can make simply getting through the day feel like running a marathon

Expert Rev Gastroenterol Hepatol 2010;4(2):191-215