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PMID 11367383

A., Wilton, P., Albertsson-Wikland, K

Vitamin B12 has a good safety profile, but some important considerations include rare hypersensitivity reactions (including anaphylaxis) with injections, potential hypokalaemia during early treatment of severe deficiency, and possible cutaneous reactions

In response to the concerns noted above that reduce the sensitivity and specificity of serum B12 and confound the diagnosis of B12 deficiency, many investigators now recommend measuring one functional B12 biomarker (serum methylmalonic acid or serum homocysteine) if serum B12 concentrations appear inadequate to ensure a more accurate assessment of B12 status

Individuals on long-term medications such as metformin for diabetes or proton pump inhibitors for acid reflux, both of which block B12 absorption

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