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Yet, conditions like leaky gut, irritable bowel syndrome (IBS), and chronic inflammation disrupt this delicate balance, leading to various health concerns

If the patient is suspected to be sensitive to cobalt or other components of cobalamin, an intradermal test dose is recommended.[12][15] Several laboratory tests should be performed prior to treatment with cyanocobalamin, including serum vitamin B12, folate, iron, hematocrit, and reticulocyte count

Many capsules contain fillers (microcrystalline cellulose, rice flour, or similar)

doi:10.1002/1529-0131(200201)46:1 3.0.CO;2-H

You might have poor immunity, white marks on your nails, slow healing of wounds, and a very low appetite