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We flag it only to be complete and honest about where the science actually stands, because responsible information means clearly separating what is proven from what is still being studied

All reported side effects were mild to moderate in severity, with no severe treatment-related adverse effects documented

Adequate B12 levels reduce the risk of neural tube defects like spina bifida and anencephaly, while B12 deficiency increases the risk by up to three times

Golding points out that unless the enterohepatic circulation is disrupted, holotranscobalamin levels wont significantly decrease until the livers B12 stores are depleted (Golding, 2016)

Then, the dose might change based on how you react and other factors