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Clegg LE, Penland RC, Bachina S, et al

However, a 2021 case report found that choline injections caused severe skin inflammation and hard nodules in the areas of administration

The most common forms used are cyanocobalamin (stable, widely available) and methylcobalamin (the active form, preferred by some providers for neurological support)

Other people may develop osteomyelitis, a deep infection of the nasal bones that is difficult to treat and often requires long-term antibiotics or surgery

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[80] used hydrophilic interaction liquid chromatography, electron ionization, and tandem mass spectrometry to target 612 metabolites in plasma, and identified disturbances across 20 biochemical metabolic pathways