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Oral supplements, on the other hand, may not be as effective for individuals with digestive issues

Credit: Kirkland Signature Pros Affordable, potent source of B12 USP-verified No synthetic dyes or artificial flavors Cons Very high dose may cause digestive upset Contains a small amount of sucralose Individuals who are severely deficient in B12 may be advised by their healthcare provider to opt for a higher, extra-strength dose of the nutrient

The vitamin B12 used for supplements is cyanocobalamin, which is manufactured chemically

Areas Without Adequate Human Evidence Cardiovascular safety Neurological and psychiatric effects Liver and kidney safety Effects on blood glucose in humans Effects on methylation pathways Genotoxicity Carcinogenicity Reproductive and developmental toxicity Use during pregnancy or breastfeeding Interactions with prescription medicines Interactions with supplements or research compounds Long-term exposure Product-Quality Risks Incorrect quinolinium compound Wrong substitution position Incorrect counterion Incorrect active-content calculation Residual starting materials Residual solvents Degradation products Heavy-metal or inorganic contamination Mismatched certificate of analysis Uncontrolled storage and transport Absence of published harm is not proof of safety A compound without routine regulated human exposure may generate very few formal safety reports simply because there is no organised pharmacovigilance system