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Hydroxocobalamin is bound to plasma proteins and stored in the liver

By beginning at a small dose, the body is able to gradually adjust, which reduces the side effects

Fluctuating Side Effects and Restarting Challenges Paradoxically, while some individuals extend doses to manage side effects, this approach can lead to its own set of challenges: Unpredictable Side Effect Patterns: The gastrointestinal side effects (nausea, constipation, diarrhea) that some people seek to mitigate by extending doses can become more unpredictable

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Used alone, it can make the formula sticky and it is a good team player so it is usually combined with other thickeners and so-called rheology modifiers (helper ingredients that adjust the flow and thus the feel of the formula)