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The choice between cyanocobalamin and hydroxocobalamin might also depend on the neurological symptoms

PMID 24803097

These include: Nausea, vomiting, and diarrhoea (very common, especially during dose escalation) Reduced appetite and abdominal discomfort Constipation Risk of hypoglycaemia when used with insulin or sulphonylureas Pancreatitis and gallbladder disease have been reported Thyroid C-cell tumours have been observed in animal studies, though the relevance to humans is unknown Important safety considerations when using both treatments include: Mounjaro can reduce the effectiveness of oral contraceptives due to delayed gastric emptying

People on certain medication

Effect of clozapine and adjunctive high-dose glycine in treatment-resistant schizophrenia