Some medications, such as metformin (used for diabetes), may affect B12 absorption rather than conversion
Serious safety concerns are rare but include: Systemic infections : Immunocompromised individuals, those with central venous catheters, or patients with damaged gut barriers face increased risk of bacteremia or fungemia from probiotic organisms [19] [20] Antibiotic resistance transfer : Some probiotic strains may carry antibiotic resistance genes Metabolic complications : Rare cases of D-lactic acidosis have been reported with high-dose probiotic use [25] Specific populations requiring caution include patients with severe acute pancreatitis (based on the PROPATRIA trial showing increased mortality), short bowel syndrome, immunosuppression (HIV/AIDS, chemotherapy, organ transplant recipients), and critically ill individuals
Other side effects can include fatigue, headache, hair loss, vomiting and burping
Sexual dysfunction, affecting both men and women, is often overlooked but significantly impacts quality of life
If exogenous ochronosis is present on the skin, multiple sessions of chemical peels and laser treatment for hyperpigmentation (Q-switched NDYAG) would be needed in addition to the skincare products and IV antioxidant therapies
Heres what to look for and how to course-correct
