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Cyanocobalamin (synthetic) is more widely available, more affordable, and well-studied

Diarrhea associated with weight loss injections likely results from multiple factors, though the precise mechanisms are not fully understood

Contraindications include Leber's hereditary optic neuropathy (B12 can worsen vision loss), acute gout flares, and hypersensitivity to any component

However, anecdotal reports from online forums cited in a 2025 systematic review included anxiety and panic attacks, depression and anhedonia, insomnia, heart palpitations, fatigue and weakness, and loss of appetite

B12 shots commonly cause localized pain, while IV infusions carry additional considerations related to venous access and fluid delivery

NHS reports common side effects such as mild skin irritation and rare severe reactions