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This article examines the side effect profile of B12 therapy in older adults, covering common reactions such as injection site discomfort and gastrointestinal symptoms, rare serious adverse events requiring urgent medical attention, important drug interactions with medications like proton pump inhibitors and metformin, and evidence-based dosing guidance aligned with NICE and BNF recommendations for safe, effective B12 replacement in this vulnerable population

Prolonged use of Vitamin B6 (over 2 months) at high doses exceeding 1g/day can lead to severe peripheral neuropathy, with symptoms including unsteady gait and numbness in the hands and feet

14 Other major medical organizations do not have any recommendations for screening low-risk patients