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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

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Often, a 10mg vial of B12 costs around $50

[6] Children in some regions of developing countries are at particular risk due to increased requirements during growth coupled with diets low in animal-sourced foods

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