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[7] Niacin can cause vasodilation, so it should be avoided in those with serious hypotension

People who take medications regularly that decrease stomach acid production can also become deficient in vitamin B12 for this reason, whether they consume enough from their diets or not

If you are self-supplementing with high-dose B12 without medical indication, discuss this with your GP

Unexplained elevated B12 levels warrant medical investigation including liver function tests, renal function assessment, and full blood count

The body's ability to absorb B12 from food can diminish with age because stomach acid is required to release B12 from dietary proteins