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10.1186/s13018-019-1242-6 54 PetrovicI.DobricI.DrmicD.SeverM.KlicekR.RadicB.et al (2011)

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Reported Adverse Effects From the limited human studies and anecdotal reports from users, the following side effects have been documented: Injection site pain and local reactions Joint pain or exacerbation of existing joint discomfort Anxiety and mood disturbances Palpitations and cardiovascular symptoms Insomnia or sleep disruption Nausea and gastrointestinal discomfort The frequency and severity of these effects remain unclear because no systematic adverse effect monitoring has been conducted across a large human population

28 However, oral therapy does not improve serum methylmalonic acid levels as well as intramuscular therapy, although the clinical relevance is unclear

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