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Some patients may experience a transient increase in acne or rosacea-like skin reactions, thought to be related to the effects of vitamin B12 on skin bacteria, though this is uncommon and typically mild

this is a maximum hypersensitivity reaction of the immune system with varying degrees of severity, but which can be acutely life-threatening (Bilwani et al., 2005)

Some notice a boost in energy within hours, while others experience gradual improvements as B12 levels increase

Additionally, liver disease may increase production or release of haptocorrin itself, further elevating total B12 measurements even when functional B12 delivery to tissues may be impaired