| Ingredients | Amount Per Serving |
|---|---|
| 1000 mcg | |
|
Raw Probiotic & Enzyme Blend
|
100 mcg |
|
(Saccharomyces boulardii )
|
|
|
Beta-Glucanase
|
|
|
Alpha-Galactosidase
(AGS)
|
|
|
Hemicellulase
|
|
|
Cellulase
|
|
|
Raw Organic Fruit & Vegetable Blend
|
20 mg |
|
(fruit)
|
|
|
(fruit)
|
|
|
(fruit)
|
|
|
(fruit)
|
|
|
(fruit)
|
|
|
(root)
|
|
|
organic Carrot juice
(root)
|
|
|
organic Spinach juice
(leaf)
|
|
|
organic Broccoli juice
(flower & stem)
|
|
|
organic Tomato juice
(fruit)
|
|
|
organic Kale juice
(leaf)
|
|
|
organic Red Cabbage juice
(leaf)
|
|
|
organic Parsley juice
(leaf)
|
|
|
organic Brussels Sprout juice
(leaf)
|
|
|
Organic Green Bell Pepper Juice
(fruit)
|
|
|
(gourd)
|
|
|
organic Celery juice
(stalk)
|
|
|
organic Garlic juice
(bulb)
|
|
|
organic Ginger juice
(root)
|
|
|
organic Green Onion juice
(root)
|
|
|
organic Cauliflower juice
(flower & stem)
|
|
|
organic Asparagus juice
(flower & stem)
|
Vegetable Cellulose, Brewer's Yeast Genus: Saccharomyces Species: cerevisiae, Lactobacillus bulgaricus Genus: Lactobacillus Species: bulgaricus Note: Guaranteed per serving, at time of manufacture.
Below is general information about the effectiveness of the known ingredients contained in the product Raw B-12. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of blackberry.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
Proteolytic enzymes represent a wide group of enzymes that are used alone or in combination. See specific monographs for effectiveness information.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
Below is general information about the safety of the known ingredients contained in the product Raw B-12. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
LIKELY SAFE ...when used in amounts commonly found in foods.
POSSIBLY SAFE ...when used orally and appropriately for medicinal purposes, short term. Beetroot juice has been safely used in clinical trials in doses of up to 500 mL daily for up to 7 days and a beetroot-based nutritional gel has been used safely in doses of up to 100 grams daily for 8 days (94461,94462,94464,100149,100152,100153).
PREGNANCY AND LACTATION:
There is insufficient reliable information available about the safety of beets used medicinally during pregnancy and breast-feeding.
LIKELY SAFE ...when the fruit is used orally in amounts commonly found in foods (4912). There is insufficient reliable information available about the safety of blackberry fruit or leaf when used in medicinal amounts.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using in amounts greater than those found in foods.
LIKELY SAFE ...when used orally and appropriately. Blueberry, as the whole fruit, juice, or in a powder formulation, is safe when consumed in amounts commonly found in foods (13533,92387,92388,92394,96467,97181,99139). There is insufficient reliable information available about the safety of blueberry when used topically or when the leaves are used orally.
CHILDREN: LIKELY SAFE
when used orally and appropriately in amounts commonly found in foods (13533,96465).
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in amounts commonly found in foods (13533,107281).
There is insufficient reliable information available about the safety of blueberry for medicinal use; avoid using.
LIKELY SAFE ...when used in food amounts. Cucumbers are a common food source (103382,103385). ...when the extract, fruit, fruit extract, fruit water, juice, seed extract, and seed oil are used topically and appropriately. These ingredients have been shown to be safely used in cosmetic products in levels of 0.4% to 3% (103382,103395).
POSSIBLY SAFE ...when cucumber extract or cucumber seed extract is used orally and appropriately. A specific cucumber extract (Q-Actin) has been used with apparent safety in doses of up to 10 mg twice daily for 6 months (103385). Cucumber seed extract has been used with apparent safety in doses of up to 500 mg daily for 6 weeks (103386). There isn't enough reliable information to know if other cucumber products are safe to use in amounts greater than those found in food.
PREGNANCY AND LACTATION:
There is insufficient reliable information available about the safety of cucumber in amounts greater than those found in foods; avoid using.
LIKELY SAFE ...when consumed in the amounts commonly found in foods. There is insufficient reliable information available about the safety of phytase when used orally as a supplement.
PREGNANCY AND LACTATION:
Insufficient reliable information is available; avoid using.
POSSIBLY SAFE ...when used orally and appropriately. Various proteolytic enzymes have been safely used orally in clinical research (716,964,965,968,969,6252,6253,10622,11457,18281,18284) (91104,91105,91106,91111,96449). Side effects are typically mild to moderate and most often include gastrointestinal effects. See specific monographs for more detailed information related to the safety of individual proteolytic enzymes. ...when used topically and appropriately. Various proteolytic enzymes have been safely used topically in clinical research (67835,67843,67845,91113). Some proteolytic enzymes might cause allergic reactions when used topically. See specific monographs for more detailed information related to the safety of individual proteolytic enzymes.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when the fruit is used orally in amounts commonly found in foods (13622).
POSSIBLY SAFE ...when the fruit is used orally and appropriately in medicinal amounts (6481,9796). There is insufficient reliable information available about the safety of red raspberry leaf when used orally or topically.
PREGNANCY: LIKELY SAFE
when the fruit is used orally in amounts commonly found in foods (13622).
PREGNANCY: POSSIBLY SAFE
when red raspberry leaf is used orally and appropriately in medicinal amounts during late pregnancy under the supervision of a healthcare provider.
Red raspberry leaf is used by nurse midwives to facilitate delivery. There is some evidence that red raspberry leaf in doses of up to 2.4 grams daily, beginning at 32 weeks' gestation and continued until delivery, can be safely used for this purpose (6481,9796). Make sure patients do not use red raspberry leaf without the guidance of a healthcare professional.
PREGNANCY: LIKELY UNSAFE
when red raspberry leaf is used orally in medicinal amounts throughout pregnancy or for self-treatment.
Red raspberry leaf might have estrogenic effects (6180). These effects can adversely affect pregnancy. Tell pregnant patients not to use red raspberry leaf at any time during pregnancy without the close supervision of a healthcare provider.
LACTATION: LIKELY SAFE
when the fruit is used orally in amounts commonly found in foods (13622).
There is insufficient reliable information available about the safety of red raspberry leaf; avoid using.
LIKELY SAFE ...when used orally and appropriately for up to 15 months (155,4347,4350,4351,4352,4353,4354,7140,7646,7652),(12763,14334,14379,14380,14381,72194,72198).
CHILDREN: POSSIBLY SAFE
when used orally and appropriately in children of most ages (4347,4356,14334,72145,92806,98734,103451,107603,107605,111102)(111103).
There is insufficient reliable information available about the safety of Saccharomyces boulardii in preterm infants with a birth weight under 1000 grams. Cases of bacteremia have occurred rarely in preterm infants given other probiotics (102416,111610,111612,111613,111850,111852,111853). The US Food and Drug Administration (FDA) has issued a warning about cases of serious infections caused by probiotics reported in very preterm or very low birth weight infants under 1000 grams (111610). Similarly, the American Academy of Pediatrics does not support the routine administration of probiotics to these infants due to conflicting data on safety and efficacy (111608).
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when the fruit is consumed in amounts commonly found in foods (14056,14058,93197,94712). ...when the fruit is used orally in medicinal amounts, short-term. Sweet cherry 280 grams daily for 28 days has been safely used in clinical research (94712). There is insufficient reliable information available about the safety of sweet cherry when used orally in medicinal amounts, long-term.
PREGNANCY AND LACTATION: LIKELY SAFE
when the fruit is consumed in amounts commonly found in foods (14056,14058).
There is insufficient reliable information available about the safety of sweet cherry when used in medicinal amounts during pregnancy or lactation.
LIKELY SAFE ...when used orally, topically, intravenously, intramuscularly, or intranasally and appropriately. Vitamin B12 is generally considered safe, even in large doses (15,1344,1345,1346,1347,1348,2909,6243,7289,7881)(9414,9416,10126,14392,15765,82832,82949,82860,82864,90386)(111334,111551).
PREGNANCY: LIKELY SAFE
when used orally in amounts that do not exceed the recommended dietary allowance (RDA).
The RDA for vitamin B12 during pregnancy is 2.6 mcg daily (6243). There is insufficient reliable information available about the safety of larger amounts of vitamin B12 during pregnancy.
LACTATION: LIKELY SAFE
when used orally in amounts that do not exceed the recommended dietary allowance (RDA).
The RDA of vitamin B12 during lactation is 2.8 mcg daily (6243). There is insufficient reliable information available about the safety of larger amounts of vitamin B12 while breastfeeding.
Below is general information about the interactions of the known ingredients contained in the product Raw B-12. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Theoretically, beet might decrease the levels and clinical effects of CYP1A2 substrates.
 Details
In vitro research suggests that beet induces CYP1A2 enzymes (111404).
|
Theoretically, beet might increase the levels of CYP3A4 substrates.
Details
In vitro research suggests that betanin, the major pigment in beet, competitively inhibits CYP3A4 in a dose-dependent manner similarly to strong CYP3A4 inhibitor ketoconazole (113425).
|
Theoretically, blueberries or blueberry leaf extracts might increase the risk of hypoglycemia when taken with antidiabetes drugs.
Details
|
Theoretically, blueberry juice might increase blood levels of buspirone.
Details
In vitro research shows that blueberry juice can inhibit the metabolism of buspirone, possibly by inhibiting cytochrome P450 3A (CYP3A) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking buspirone hydrochloride 10 mg does not significantly affect the concentration or clearance of buspirone (92385).
|
Theoretically, blueberry juice might increase blood levels of flurbiprofen.
Details
In vitro research shows that blueberry juice can inhibit the metabolism of flurbiprofen, possibly by inhibiting cytochrome P450 2C9 (CYP2C9) enzymes. However, pharmacokinetic research in humans shows that drinking 300 mL of blueberry juice 30 minutes before taking flurbiprofen 100 mg does not significantly affect the concentration or clearance of flurbiprofen (92385).
|
Theoretically, cucumber seed might have additive effects with antidiabetes drugs and may increase the risk of hypoglycemia.
Details
Animal research shows that cucumber seed extract can decrease blood glucose levels (103391). Monitor blood glucose levels closely.
|
Theoretically, taking red raspberry leaf with anticoagulant/antiplatelet drugs might increase the risk of bleeding.
Details
In vitro research suggests that red raspberry leaf extract has antiplatelet activity and enhances the in vitro effects of the antiplatelet medication cangrelor (96300). This interaction has not been reported in humans.
|
Red raspberry leaf might reduce glucose levels in patients being treated with insulin.
Details
In one case report, a 38-year-old patient with gestational diabetes, whose blood glucose was being controlled with medical nutrition therapy and insulin, developed hypoglycemia after consuming two servings of raspberry leaf tea daily for 3 days beginning at 32 weeks' gestation. The patient required an insulin dose reduction. The hypoglycemia was considered to be probably related to use of red raspberry leaf tea (96299).
|
Theoretically, taking antifungals with Saccharomyces boulardii might decrease the effectiveness of Saccharomyces boulardii.
Details
S. boulardii is a live yeast. Therefore, simultaneously taking antifungals might kill a significant number of the organisms (4363).
|
In vitro and animal research suggests that strawberry extract can inhibit platelet aggregation due to its phenolic content (76472,76488). Theoretically, strawberry might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Details
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
|
In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux (76474,76476). Theoretically, strawberry might inhibit p-glycoprotein mediated drug efflux and potentially increase levels of drugs that are substrates of p-glycoprotein. Until more is known, strawberry should be used cautiously in people taking p-glycoprotein substrates.
Details
Drugs that might be affected include some chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
|
Below is general information about the adverse effects of the known ingredients contained in the product Raw B-12. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
General
...Orally, beet seems to be well tolerated when used for medicinal purposes, short term.
Most Common Adverse Effects:
Orally: Red stools and red urine.
Serious Adverse Effects (Rare):
Orally: Hypocalcemia and kidney damage when ingested in large amounts.
Endocrine ...Theoretically, ingestion of large quantities of beets could lead to hypocalcemia because of the oxaluric acid content (18).
Gastrointestinal
...Orally, beet juice may cause red stools (94470,97726,100142,100145,105762).
This red coloring of the stools is not harmful. Additionally, beet supplementation has been reported to cause black stools. In one case, a 79-year-old male on apixaban and clopidogrel presented with black stools, nausea, and vomiting after taking beet pills 2-3 days prior. The likelihood of upper gastrointestinal bleed was determined to be low based on factors such as normal vital signs and lack of severe anemia. The patient was diagnosed with beet-induced pseudo-hematochezia which was successfully treated with fluids and discontinuation of the beet supplement (113426).
Other less common gastrointestinal side effects include loose stools, constipation, and nausea (100149).
Genitourinary ...Orally, beet is known to produce red or pink urine (beeturia) in some people (32569,34134,94464,94470,97725,97726,100142,100145,100152,105762,113422). However, this red coloring of the urine is not harmful and dissipates after about 12 hours (113422).
Neurologic/CNS ...Orally, vivid dreams and worsening headaches have each occurred in one person in a clinical trial, although it is not clear if this is due to beet (97723).
Renal ...Theoretically, ingestion of large quantities of beets could lead to kidney damage due to its oxaluric acid content (18).
General ...Blackberry fruit is commonly consumed as a food without reports of adverse effects. However, a thorough evaluation of safety outcomes for blackberry when used as a medicine has not been conducted.
General
...Orally, blueberry is generally well tolerated.
Most Common Adverse Effects:
Orally: Constipation, diarrhea, nausea, and vomiting with freeze-dried blueberries.
Gastrointestinal ...Orally, freeze-dried blueberries may cause constipation, diarrhea, nausea, and vomiting. In one clinical trial, 26% of patients taking freeze-dried blueberries 50 grams daily dropped out in the first week of the study due to gastrointestinal complaints (107278).
General
...Orally, cucumber is well tolerated in food amounts.
Cucumber extract and seed extract also seem to be well tolerated. Topically, the extract, fruit, fruit extract, fruit water, juice, seed extract, and seed oil of cucumber are well tolerated.
Most Common Adverse Effects:
Topically: Allergic eczema, erythema, irritation.
Serious Adverse Effects (Rare):
Orally: Anaphylaxis.
Dermatologic ...Topically, mild redness and irritation have occurred rarely (103382).
Immunologic
...Orally, anaphylaxis with dizziness, vomiting, trouble breathing, and itching, occurring 5 minutes after eating a partially peeled cucumber, has been reported in a 76-year-old woman (103382,103384).
Topically, allergic eczema related to exposure to cucumber leaves and stems has been reported in a greenhouse worker (103382,103393).
General ...Orally, no adverse effects have been reported. However, a thorough evaluation of safety outcomes has not been conducted. Workplace immunological responses to airborne powdered phytase have been reported (101901,101908,101909,101910).
Immunologic ...There are numerous reports of immunologic responses to airborne powdered phytase in the animal-feed industry (101901,101908,101909,101910). Examples of reactions include allergic occupational asthma and hypersensitivity pneumonitis (101901,101908). In one case report of a 43-year-old male, hypersensitivity pneumonitis related to phytase was diagnosed following a 6-month history of coughing, shortness of breath, fever, and dyspnea (101908). In an analysis of 53 people occupationally exposed to phytase, 28% had IgE antibodies and 45% had IgG antibodies specific to phytase. Symptoms included dyspnea, rhinitis, and eye and skin reactions (101909). In another analysis of patients with IgE-mediated occupational respiratory allergy, wheezing, chest tightness, shortness of breath, cough, and asthmatic symptoms were reported (101910).
General
...Orally, proteolytic enzymes are generally well tolerated.
See specific monographs for detailed safety information related to individual proteolytic enzymes.
Most Common Adverse Effects:
Orally: Gastrointestinal upset.
Serious Adverse Effects (Rare):
Topically: Allergic reactions.
Gastrointestinal ...Orally, some patients taking proteolytic enzymes may have gastrointestinal complaints (101517).
Immunologic ...Proteolytic enzymes are commonly found in laundry detergents and pre-spotter products. Rarely, protease specific IgE positive tests possibly related to these products have occurred. Exposure may be airborne or topical (102705). In addition, in case reports, occupational exposure to the airborne proteolytic enzyme pepsin has resulted in allergic rhinoconjunctivitis or asthma (102706,102707).
General
...Orally, red raspberry fruit is well tolerated.
There is currently a limited amount of information on the adverse effects of red raspberry leaf.
Most Common Adverse Effects:
Orally: Diarrhea, gastrointestinal upset, and epigastric pain. However, these adverse effects do not commonly occur with typical doses.
Dermatologic ...A liquid containing red raspberry leaf cell culture extract 0. 0005%, vitamin C 20%, and vitamin E 1% (Antioxidant and Collagen Booster Serum, Max Biocare Pty Ltd.) has been reported to cause mild tingling and skin tightness (102355). It is unclear if these effects are due to red raspberry leaf, the other ingredients, or the combination.
Gastrointestinal ...Orally, red raspberry may cause gastrointestinal upset, diarrhea, and epigastric pain (112127).
Pulmonary/Respiratory ...A case of occupational asthma due to the inhalation of red raspberry powder has been reported for a 35-year-old female. Symptoms included wheezing and shortness of breath (70370).
General
...Orally, Saccharomyces boulardii is generally well tolerated.
Serious Adverse Effects (Rare):
Orally: There is concern that Saccharomyces boulardii may cause fungemia in certain patients.
Gastrointestinal ...Rarely, oral use of Saccharomyces boulardii has caused gastrointestinal complaints, such as abdominal cramps, flatulence, nausea, vomiting, and decreased appetite (98731,107608).
Immunologic
...Rarely, oral use of Saccharomyces boulardii has been associated with fungemia in both immunocompromised and immunocompetent patients (1247,4357,4358,4360,7329,14459,72121,72126,72142,92809,95357,95363)(96277,105171,107604,107607).
Numerous cases of Saccharomyces fungemia have been reported in critically ill intensive care unit (ICU) patients, particularly those with indwelling or central venous catheters, those receiving enteral feeding, or those receiving broad-spectrum antibiotics. Most infections occurred when packets of Saccharomyces were used or when Saccharomyces capsules were opened at the bedside (12776,12777,14459,95358,95360,95362,95363,105171). Admission to the ICU and extended length of stay increase the risk of developing Saccharomyces fungemia (107604). In a hospitalized 1-year-old patient with severe malnutrition and multiple invasive devices, Saccharomyces cerevisiae fungemia developed 2 days after receiving a probiotic containing S. boulardii 200 mg twice daily for 4 days (96277). In addition, there are two case reports of S. cerevisiae fungemia in hospitalized and intubated older patients with COVID-19 who had been given S. boulardii for diarrhea (105171).
The true incidence of fungemia is difficult to determine with S. boulardii. Most clinical laboratories are unable to differentiate between S. boulardii and S. cerevisiae, which might come from other sources (7353). In two case reports of patients in the ICU, there was a 100% alignment of fungal ribosomal DNA ITS sequences between the strains found in the blood of the infected patients and the strains of S. boulardii that had been administered (105171). In a large analysis of hospitalized patients, the incidence rate of Saccharomyces fungemia was 0.11% of those given S. boulardii and did not occur in patients not given this probiotic. Packets or capsules opened at a distance from the patient in the hospital were included in this analysis (107604).
Positive Saccharomyces cultures have also been obtained rarely from other sites, such as the abdominal region and the oral or respiratory tract (107607).
An elevated erythrocyte sedimentation rate may occur when S. boulardii is used to treat Crohn disease (7646), but this effect may be a natural part of the disease process.
General
...Orally, strawberry is well tolerated when taken in the amounts commonly found in food.
When taken in medicinal amounts, strawberry seems to be generally well tolerated (100109,100113,100116,100119). Rarely, strawberry has been reported to cause nausea and allergic reactions, including oral allergy syndrome and skin reactions (100113,100119,103880).
Topically, strawberry can cause contact dermatitis (13637).
Gastrointestinal ...Orally, taking freeze-dried strawberry powder 50 grams daily has been reported to cause nausea in clinical trials (100113,100119).
Immunologic ...Orally, consuming strawberry has been reported to cause allergic reactions, including oral allergy syndrome and skin reactions, in some patients. (103880). Topically, strawberry has caused contact urticaria in one case report (13637). Overall, allergy to strawberry appears to be rare (103880).
General ...Orally, sweet cherry is generally well tolerated.
Immunologic ...Orally, sweet cherry can cause allergic reactions in sensitive patients. These reactions can range from mucosal irritation to urticaria, angioedema, dyspnea, cough, and gastrointestinal symptoms (14057).
General
...Orally, intramuscularly, and topically, vitamin B12 is generally well-tolerated.
Most Common Adverse Effects:
Intramuscular: Injection site reactions.
Serious Adverse Effects (Rare):
Intramuscularly: Severe hypokalemia has been rarely linked with correction of megaloblastic anemia with vitamin B12.
Cardiovascular ...In human clinical research, an intravenous loading dose of folic acid, vitamin B6, and vitamin B12, followed by daily oral administration after coronary stenting, increased restenosis rates (12150). Hypertension following intravenous administration of hydroxocobalamin has been reported in human research (82870,82864).
Dermatologic
...Orally or intramuscularly, vitamin B12 can cause allergic reactions such as rash, pruritus, erythema, and urticaria.
Theoretically, allergic reactions might be caused by the cobalt within the vitamin B12 molecule (82864,90373,90381,103974). In one case report, oral methylcobalamin resulted in contact dermatitis in a 59-year-old Japanese female with a cobalt allergy (103974). In another case report, a 69-year-old female developed a symmetrical erythematous-squamous rash for 5 years after oral vitamin B12 supplementation for 10 years. A patch test confirmed that the systemic allergic dermatitis was due to vitamin B12 supplementation, which resolved 3 months after discontinuation (114578).
Vitamin B12 (intramuscular or oral) has also been associated with at least 19 cases of acneiform eruptions which resolved upon discontinuation of vitamin B12 (90365,90369,90388). High-dose vitamin B12 (20 mcg daily) and vitamin B6 (80 mg daily) have been associated with cases of rosacea fulminans characterized by intense erythema with nodules, papules, and pustules. Symptoms may last up to four months after the supplement is stopped and can be treated with systemic corticosteroids and topical therapy (10998,82870,82871).
Gastrointestinal ...Intravenously, vitamin B12 (hydroxocobalamin) 2. 5-10 grams can cause nausea and dysphagia (82864).
Genitourinary ...Intravenously, vitamin B12 (hydroxocobalamin) 5-15 grams has been associated with chromaturia in clinical research (82870,82871,112282,112264).
Hematologic ...According to case report data, the correction of megaloblastic anemia with vitamin B12 may result in fatal hypokalemia (82914).
Musculoskeletal ...According to case report data, correction of megaloblastic anemia with vitamin B12 has precipitated gout in susceptible individuals (82879).
Neurologic/CNS ...Treatment with vitamin B12 has been rarely associated with involuntary movements in infants with vitamin B12 deficiency (90370,90385,90397). In some cases these adverse reactions were misdiagnosed as seizures or infantile tremor syndrome (90370,90385). These adverse reactions presented 2-5 days after treatment with vitamin B12 and resolved once vitamin B12 was discontinued (90370,90385,90397).
Oncologic ...Although some epidemiological research disagrees (9454), most research has found that elevated plasma levels of vitamin B12 are associated with an increased risk of various types of cancer, including lung and prostate cancers and solid tumors (50411,102383,107743). One study found, when compared with blood levels of vitamin B12 less than 1000 ng/mL, plasma vitamin B12 levels of at least 1000 ng/mL was strongly associated with the occurrence of solid cancer (107743). It is unclear if increased intake of vitamin B12, either through the diet or supplementation, directly affects the risk of cancer. It is possible that having cancer increases the risk of vitamin B12 elevation. However, one observational study has found that the highest quintile of dietary intake of vitamin B12 is associated with a 75% increased incidence of developing esophageal cancer when compared with the lowest quintile in never drinkers, but not drinkers (107147).
Renal ...There is a case report of oxalate nephropathy in a 54-year-old male which was determined to be related to the use of intravenous hydroxocobalamin as treatment for cyanide poisoning. Intermittent hemodialysis was started 5 days after admission, along with a low-oxalate diet, oral calcium acetate, and pyridoxine 5 mg/kg daily (107148). A review of the use of intravenous hydroxocobalamin for suspected cyanide poisoning in 21 intensive care units in France between 2011 and 2017 resulted in a 60% increased odds of acute kidney injury and a 77% increased odds of severe acute kidney injury in the first week. However, biopsies were not conducted and a direct link with use of hydroxocobalamin could not be made (107139).
Other ...Several studies have found that higher vitamin B12 levels may be associated with increased mortality or decreased survival rates in hospitalized elderly patients (82889,82812,82857,82895). Human research has also found a positive correlation between vitamin B12 status and all-cause mortality in Pima Indians with diabetes (82863).
