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Although rare, adverse effects of high-dose vitamin B12 have been reported, including allergic reactions such as fever, rash, itching, hot flushes, dizziness, and nausea, across all cobalamin forms and administration routes ( Intramuscular (IM) injection is the most invasive and costly administration method, requiring trained personnel and clinical visits

Glade, M

This makes oral delivery the preferred route for GI-specific indications, while injectable delivery is preferred for systemic tissue repair goals (joint, muscle, tendon, systemic inflammation)

Additionally, they were able to show that activation of mast cells in osteoarthritis is through IgE/FcRI