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Vitamin B12 injections have essentially no negative side effects, except for extremely rare cases in which patients are allergic or sensitive to the injection

Conditions associated with elevated B12 levels include: Liver disease : Hepatocellular damage releases stored B12 into circulation, with levels correlating with disease severity in conditions such as cirrhosis, hepatitis, and hepatocellular carcinoma Renal impairment : Reduced kidney function decreases B12 clearance, leading to accumulation Haematological malignancies : Myeloproliferative disorders, acute leukaemia, and polycythaemia vera can elevate B12 through increased production of B12-binding proteins (transcobalamins) Solid tumours : Certain cancers, particularly those affecting the liver or gastrointestinal tract, may elevate B12 levels A specific concern relates to cyanocobalamin in patients with Leber's hereditary optic neuropathy , a rare mitochondrial disorder

This is bad for B12 absorption

Managing gastrointestinal disorders such as atrophic gastritis or celiac disease can improve B12 absorption