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Vegetarians and vegans especially need to be careful and consider supplements, as most common vitamin B12 food sources do not fit with these diets

[8] Although not an absolute contraindication, patients with coronary artery disease or unstable angina should only use B-Complex injections containing niacinamide under physician supervision, since high-dose niacin supplements have been linked to arrhythmias in such patients

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Institute of Medicine (IOM) recommended dietary intake or the European Food Safety Authority (EFSA) adequate intake

For individuals receiving B12 injections for severe deficiency, there have been isolated reports of hypokalaemia (low potassium) during initial treatment, as rapid cell production consumes potassium