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Vitamin B12 side effects Side effects from vitamin B12 supplementation are rare, and only occur with B12 injections, not oral supplementation, Allen says

We know of two members of this society who use oral tablets instead of injections but they take enormous doses in order that, hopefully, some of what they swallow will be absorbed passively in their gut

It helps to picture the chemistry

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About 5-Amino-1MQ 5-Amino-1MQ (5-amino-1-methylquinolinium) is a small-molecule inhibitor of nicotinamide N-methyltransferase (NNMT), an enzyme involved in the regulation of cellular energy metabolism and NAD+ biosynthesis