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If more than 4 days have passed, skip the missed dose and resume your regular weekly schedule

Some animal and early-phase studies noted elevated inflammatory cytokines (IL-6, TNF-) at higher doses, though clinical relevance in humans at therapeutic doses remains unclear

The trial exhibited a favorable safety profile with mostly mild to moderate gastrointestinal adverse events, including diarrhea (38% versus 19% in placebo), constipation (27% versus none), and appetite loss (31% versus 8%)

For this reason, those eating a vegetarian or a vegan diet are more prone to B12 deficiency