Any excess is filtered out of your system and excreted through your urine
For patients who have difficulty absorbing B12 through the digestive tractsuch as those with pernicious anemia, gastrointestinal disorders (like Crohns disease or celiac disease), a history of gastric bypass surgery, or those with severe B12 deficiencyour providers often recommend intramuscular B12 injections
Deficiency vs
In summary, the key interactions to consider are pyridoxines reduction of levodopa and anticonvulsant efficacy, niacinamides additive effects on blood pressure, blood sugar, and gout management, and the potential need for B-vitamin repletion in patients on certain medications (diuretics, isoniazid, etc.)
These effects are particularly noticeable in individuals with a B12 deficiency or conditions like chronic fatigue syndrome or anemia, where long-term treatment can significantly improve quality of life