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PCAC member Elizabeth Rebello, a professor in the Department of Anesthesiology and Perioperative Medicine at the University of Texas MD Anderson Cancer Center, cited the "lack of efficacy data and randomized controlled trials" as her basis for her no vote

Heart neuropathy: Some evidence suggests that vitamin B12 deficiency might also contribute to autonomic cardiac neuropathy, a type of neuropathy of the heart

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Anti-inflammatory and cytoprotective effects were noted in a systematic review in 2024 and are also said to include attenuating oxidative stress and reinforcing gastrointestinal mucosal barriers during experimental injury