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This is part of why B12 has a strong safety record, and it is also why levels sometimes need regular replenishment during active treatment

Activation of the UPR generally serves as a readout for ER stress, but it is not clear what diminished UPR signaling implies in terms of actual accumulation of unfolded proteins, particularly because some stressors, such as palmitate loading, activate the UPR apparently independent of the protein folding process (Volmer et al., 2013)

Common side effects include: Nausea Constipation or diarrhea Decreased appetite Heartburn Fatigue or dizziness B12 helps reduce fatigue and may ease gastrointestinal discomfort for some users

Marks N., Stern F., Kastin A.J., and Coy D.H., 1977

Avoid acetaminophen (Tylenol) as this can harm your liver if you still have alcohol in your system