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Lipotropic injections are generally not recommended during pregnancy or breastfeeding, for people with a known allergy to any component of the formulation (including B12/cobalt), for those with certain kidney or liver conditions, or for those with certain medical conditions

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Starting supplements without testing may lead to unnecessary health risks

While the IOM had based B12 needs on the amount required to correct hematological parameters for people with pernicious anemia, the EFSA had almost 20 more years of research to draw on, and concluded that the most suitable approach was basing needs on biomarkers (serum B12, holotranscobalamin, MMA, and homocysteine)