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Patients should be aware that hydroxocobalamin may cause side effects such as nausea, vomiting, and diarrhea

When gastrointestinal symptoms occur, they often relate to supplement formulation, excipients, or underlying health conditions rather than the vitamin itself

Also stated his opinion on every available paper

Neelakantan H, Vance V, Wetzel MD, Wang HY, McHardy SF, Finnerty CC, Hommel JD, Watowich SJ. Selective and membrane-permeable small molecule inhibitors of nicotinamide N-methyltransferase reverse high-fat diet-induced obesity in mice. Biochem Pharmacol. 2018 Jul;154:161-171. doi: 10.1016/j.bcp.2018.05.003. Epub 2018 May 5. PMID: 29738706; PMCID: PMC6015571

Kristi Perry, PA-C Eli Luft, PA-C Key Takeaways 1

Insurance rarely covers compounded formulations