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Still, side effects from B12 supplements are possible, especially at higher doses, and include: Headache Nausea Vomiting Fatigue Weakness Diarrhea Tingling in the hands and feet Nasal spray Vitamin B12 is also available in a nasal spray

Use of compounded medications involves potential risks and should be discussed with a qualified healthcare provider

This is true for patients with certain health issues or those who have had bad reactions

The 2024 NICE Guideline NG239 from the United Kingdoms National Institute for Health and Care Excellence similarly distinguishes between patients who can be managed with oral therapy and those who require intramuscular treatment