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Common Side Effects Hypoglycemia: The most predictable acute effect lowered blood glucose, potentially with shakiness, sweating or lightheadedness, especially if dosed fasted or with insulin [4]

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A B12 deficiency can also be the result of: Cobalamin malabsorption (intestinal diseases, gastric/intestinal resection, atrophic gastritis, pancreatic insufficiency) Low gastric intrinsic factor (dietary intake deficits are less common) Drug interactions