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PMID: 29543316

Many commercial preparations contain additional ingredients such as: Sorbitol or mannitol sugar alcohols used as sweeteners in some tablets that can cause osmotic diarrhoea when consumed in larger quantities, though the amounts in typical supplements are usually too small to cause symptoms alone [13] [14] Binding agents and fillers including lactose, which may cause symptoms in people with lactose intolerance, though tablet quantities are typically small Other additives various excipients that some individuals may be sensitive to The dose and frequency of supplementation may also influence tolerability

This would tend to lead to higher vitamin B12 blood levels, even in people being treated for pernicious anemia

patients should use backup or non-oral contraception for 4 weeks after each dose change

The specialists at San Antonio Pain Consultants will closely monitor each patients progress to determine the best course of action for their specific needs