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Common adverse effects include: Injection site reactions pain, redness, swelling, or bruising at the intramuscular injection site Gastrointestinal disturbances nausea, diarrhoea, or abdominal discomfort Headache and dizziness particularly following initial doses Skin reactions including rash, pruritus, or acne-like eruptions Flushing temporary redness of the skin Chromaturia red-coloured urine (harmless but can cause concern if unexpected) Less common but more serious reactions include: Hypersensitivity reactions ranging from mild urticaria to anaphylaxis (rare but potentially life-threatening) Hypokalaemia particularly during initial treatment when rapid cell production occurs [5] [16] Temporary changes in blood counts during correction of deficiency Interference with laboratory tests primarily with high-dose IV hydroxocobalamin used for cyanide poisoning, not typically with standard 1mg IM replacement doses Cautions and contraindications: Hypersensitivity to cobalt or vitamin B12 Cyanocobalamin should be avoided in Leber's hereditary optic neuropathy [2] [17] Chloramphenicol may reduce the haematological response to B12 therapy Patients receiving B12 injections outside clinical necessity face unnecessary risks without proven benefit

As I elaborate on in my video The Symptoms of Vitamin B12 Deficiency , these include: Abdominal distention Chronic diarrhea Shortness of breath Swollen, red, painful feet Skin darkening Bilateral useless hand syndrome Numbness and tingling in the hands and feet Muscle cramps Dizziness Cognitive disturbances Difficulty walking Erectile dysfunction Fatigue Depression Psychosis Coma Blindness Vitamin B12 Deficiency Treatment Is A Vitamin B12 Shot Better Than Taking B12 Orally
It plays a crucial role in metabolic processes like the Krebs cycle and oxidative phosphorylation