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Injection Site Reactions : Some individuals may experience redness or irritation at the injection site

Pregnancy and lactation: Maintaining normal vitamin B12 levels is especially important for pregnant and breastfeeding women, as low levels can affect fetal development and lead to developmental delays in breastfed babies

Taking the supplement between meals, on an empty stomach, is often recommended to prevent competition with other amino acids for absorption, though it can be taken with a small amount of carbohydrates to stimulate an insulin response, which has been shown to enhance the uptake of carnitine into skeletal muscle cells

(2021) who analyzed plasma proteomes from 20 female ME/CFS patients (CDC-1994 criteria) and 20 healthy controls, finding all significantly altered proteins to be elevated in ME/CFS