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Common side effects include, but may not be limited to: pain or redness at the injection site mild diarrhea pruritus (itching) increased swelling joint pain dizziness headache nervousness or anxiety Serious side effects may include: allergic reactions peripheral vascular thrombosis hypokalemia (low potassium levels) pulmonary edema (fluid build-up around or in the lungs) thrombocytosis congestive heart failure There have been reports of anaphylactic shock and death after the parenteral administration of vitamin B12

Evidence boundary The published trial record describes safety more clearly than efficacy

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Conversely, prolonged fasting or very low-calorie diets can sometimes lead to a drop in blood pressure