Common side effects include gastrointestinal discomfort, such as nausea and diarrhea
Elevated blood homocysteine, an indicator of low folate status, has been associated with an increased risk of preeclampsia, premature delivery, and low birth weight
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Acetylcholine via the vagus nerve can also stimulate some stomach acid release by stimulating M3 (muscarinic acetylcholine) receptors
Related: The Benefits of Vitamin B-12 Vitamin B12 is often presented in food that provides protein as it is bound to it
Another thing to consider is wich brand of hydroxycobalamin you use