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While most men tolerate B12 well, those with Lebers disease (a rare genetic eye disorder) should avoid injections, as high doses of B12 may worsen symptoms

Further, a secondary analysis of a trial in women at high risk for or with existing cardiovascular disease reported that high-dose supplemental B-vitamins (1 mg/day of vitamin B 12 , 50 mg/day of vitamin B6, and 2.5 mg/day of folic acid) for 7.3 years had no effect on risk of non-vertebral fractures (122)

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Those in care homes require systems to ensure regular maintenance injections are not missed