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They also play an important role in the production of brain messengers known as neurotransmitters

Gastrointestinal symptoms (more common with oral preparations): Mild nausea or upset stomach Diarrhoea (typically with very high doses) Other effects: Headache, particularly when treatment is first initiated Dizziness or light-headedness Skin reactions such as mild rash or itching Temporary reddish discolouration of urine (chromaturia) after hydroxocobalamin injections, which is harmless It is important to note that many symptoms attributed to B12 supplementation may actually represent the body's response to correcting a deficiency

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CMS pays modifier 50 claims at 150% of the unilateral rate, approximately $103.22 for bilateral CPT 20610 claims nationally in 2026