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Some individuals may experience an increase in symptoms like headaches or lethargy shortly after a B12 injection, this effect should be temporary and followed by symptom improvement

Strict vegetarians, vegans or people with an unbalanced diet can also expect vitamin B12 deficiency

Oral absorption is considered too undependable to rely on in patients with pernicious anemia or other conditions resulting in malabsorption of vitamin B 12

This means most of a high-dose supplement remains in the gastrointestinal tract, though the direct link to digestive symptoms is not well established

This is particularly important if you are part of any of the groups considered to be at high risk of B12 deficiency, including alcoholics, smokers, those on diabetes drugs, adults over 65, those with gastrointestinal disorders and those who have had surgery relating to the digestive tract