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The high dose of cyanocobalamin is generally well-tolerated due to the vitamins water-soluble nature and efficient excretion of excess amounts

NNMT (nicotinamide N-methyltransferase) is an enzyme found in fat cells and other tissues that can become overactive in certain metabolic conditions

Heart palpitations and shortness of breath: B12 deficiency can impact the cardiovascular system, leading to palpitations and a rapid heartbeat

However, if you suspect deficiency or have risk factors, consult your GP rather than self-supplementing at high doses, as proper investigation of the underlying cause is essential for appropriate management