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Sarawagi A, Soni ND, Patel AB

GI side effects common during titration

Diarrhoea (defined as three or more loose or watery stools per day) is an uncommon side effect of vitamin B12 supplementation , though it is listed as a rare or uncommon adverse reaction in the official product information for both oral cyanocobalamin and injectable hydroxocobalamin preparations

It does not disrupt the interaction between dimers in the glutaminase tetramer but binds to the hydrophobic pocket between the monomer-monomer interface of the GAC, located at the junction where the N-terminal and C-terminal of the enzyme meet the catalytic domain, thereby preventing the GAC from activating conformational changes (Wilson et al., 2013