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While supplementing with large doses of B12 will reduce MMA levels more than will smaller doses, there are no clear benefits (more info in Appendix A

Identification of genetic and epigenetic factors predisposing to excessive reactogenicity could also help identify at-risk individuals who would benefit from mitigation strategies

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Mol Cell Biol, 2004

These include skin rash or hives, weak muscles or cramps, itching, vomiting, nausea, headache, leg pain or warm, tender pain in one leg, dizziness and fatigue, frequent urination, feeling super thirsty, fast heart rate, and swelling of the extremities