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Its primary domain is inside the mitochondria, the microscopic powerhouses responsible for generating adenosine triphosphate (ATP), which is the energy currency of the cell

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If there is a lack of cobalamin in the body, methylmalonyl CoA accumulates, which presumably leads to the neurological manifestations of B12 deficiency.47912 The replenishment with parenteral cyanocobalamin causes a rapid and complete improvement of megaloblastic anemia and gastrointestinal symptoms caused by vitamin B12 deficiency

Metallomics 8 , 840852 (2016)

You can do a search on specific side-effects through the HHS VAERS system