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The activity of the gut microbiome, as determined through cecal metatranscriptome, was altered by cyanocobalamin treatment, indicating that cobalamin transport and utilization may be altered in some microbes

Mild Systemic Effects Low-grade fatigue or energy fluctuation in the first day or two, particularly for first-time recipients Mild nausea is possible, especially if the injection is received on an empty stomach Slight headache , which often resolves with hydration Urine odor changes due to B12 and methionine metabolism harmless and expected Ingredient-Specific Notes: Methionine and Choline Not all side effects are generic to injections two ingredients in the MIC formula deserve a closer look because they have compound-specific effects in some people