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No unexpected safety signals have emerged from post-marketing surveillance

Most B12 products use cyanocobalamin, which has to be metabolized by the body before it is in a usable form

Dosing regimens have ranged from 350 g per week (in vegetarians) to 2000 g per day in a study including patients with pernicious anaemia, with the most common daily dose being 1000 g per day

A 2025 meta-analysis of 16 studies involving 6,098 participants found no statistically significant difference between intramuscular, oral, and sublingual B12 supplementation routes

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