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People with megaloblastic anemia, some gut problems, or malabsorption might need both

The Symptoms of Vitamin B12 Deficiency B12 deficiency is known as The Great Masquerader. The Efficacy and Safety of Creatine for High Homocysteine Those on a healthy plant-based diet with elevated homocysteine levels despite taking sufficient vitamin B12 may want to consider taking a gram a day of contaminant-free creatine

Intramuscular (IM) Injections Intramuscular injections involve delivering the B12 injection directly into the muscle tissue

Similarly, although hepatic dysfunction can occur with large niacin doses (1-3 grams daily over months) causing elevated liver enzymes or jaundice, niacinamide at 100 mg is very unlikely to have any adverse effect on the liver