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Oral B12 supplements have to pass through the gut, and absorption can be limited especially if you have digestive issues, take certain medications like metformin or antacids, or simply have low stomach acid

Why Higher Doses Cause More GI Problems GI side effects tend to worsen at higher doses because of increased receptor stimulation

However, the disparity between mechanistic promise and clinical maturity has direct implications for patient counselling, trial design, regulatory oversight, and ethical considerations surrounding the off-label and grey-market use of these therapies

Creeks and streams may rise out of their banks

Genuine symptoms directly attributable to B12 overdose are poorly documented and exceptionally rare