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Rarely reported symptoms associated with excessive B12 intake may include: Skin reactions : Acne-like eruptions or rosacea-type dermatitis have been occasionally reported, particularly with high-dose intramuscular injections Gastrointestinal disturbance : Mild nausea, diarrhoea, or abdominal discomfort, though these are uncommon Headache : Infrequent reports of headaches following parenteral B12 administration Hypersensitivity reactions : In very rare cases, allergic reactions to injectable B12 preparations have been documented It is crucial to note that there is no established link between standard B12 supplementation and serious adverse effects

Children with Down syndrome have abnormal metabolic profiles and show increased incidence of a large number of serious diseases including leukemia and diabetes [61]