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This can result in various clinical symptoms including vomiting, diarrhea, constipation, and fatigue (1)

(3) collagen bundle content packing occasionally mildly loose (P18)

Animal Toxicology Studies Animal toxicology studies tested doses from 0.0027 mg/lb to 9.1 mg/lb via intraperitoneal, intramuscular, intravenous, and oral routes for up to 6 weeks, finding: No acute toxic or lethal dose No gross or histologic toxicity in major organs No hepatotoxicity or nephrotoxicity Negative Ames test (no mutagenicity) Negative chromosomal aberration tests (no genotoxicity) No teratogenicity in rat pregnancy studies No local injection site irritation The LD1 (minimum lethal dose) could not be achieved despite aggressive testing

- recommend reducing intervention frequency if B12 levels are elevated, and continue to monitor