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And that means it's only a matter of time before the bacteria or archaea come back

Patients with pernicious anaemia, malabsorption disorders (such as Crohn's disease or coeliac disease), or following gastric surgery require regular B12 supplementation to prevent serious complications including megaloblastic anaemia and neurological damage

Plastic and Reconstructive Surgery , 121(4), 14211429

Risk of minor injection site irritation: Local redness or small nodules can occasionally occur

Possible Side Effects While generally well-tolerated, some individuals may experience mild side effects such as: Pain, redness, or swelling at the injection site Mild diarrhea or stomach upset Allergic reactions like rash, itching, or dizziness in rare cases Headache or flushing due to niacinamide content Any persistent or severe symptoms should be reported to a healthcare professional promptly