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He started with three 1000mcg over the course of a week, but then only one a week, then one every two weeks

- Cardiac glycosides: May increase the possibility of arrhythmias or increase digitalis toxicity associated with hypokalemia

Hyperpigmentation of skin

Under-the-Tongue Tablets or Sprays : Sublingual B12 dissolves under the tongue, offering a convenient option for those with absorption issues or difficulty swallowing pills, and research supports its effectiveness[22]

For trips under 21 days with brand-name products, a basic insulated pouch with a cool pack is sufficient as long as temperatures stay below 86 degrees Fahrenheit

What about human studies