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A separate 2025 narrative review by McGuire and colleagues asked a blunter question in its title: "Regeneration or Risk?" [2] Their conclusion: the preclinical evidence is consistently positive, but the absence of human data makes it impossible to generate evidence-based practice guidelines

Common adverse effects: Injection site reactions: Pain, redness, swelling, or bruising at the injection site are frequently reported

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Although generally safe, injections should be used with caution in people with a history of allergic reactions to cobalamin or in people with Leber's disease (hereditary optic neuropathy), as B12 may worsen the condition