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[13] [15] Rare but serious side effects include hypersensitivity reactions, such as urticaria, angioedema, or anaphylaxis, which require immediate medical attention

Thrombocytopenia occurs because there is decreased production or increased destruction of platelets

Eligibility required a body mass index (BMI) of 30 kg/m or higher, or for those with at least one obesity-related comorbidity and no diabetes, a BMI of 27 kg/m or higher

However, for those supplementing, high B12 levels are generally a reflection of recent supplementation, not a cause for concern