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When administered following clinical assessment and appropriate dosing, IV B-complex is generally well tolerated

J Biol Chem 282:3264054 Humphries KM, Juliano C, Taylor SS (2002) Regulation of cAMP-dependent protein kinase activity by glutathionylation

Treatment response depends on deficiency severity, route of administration, underlying cause, patient age, concurrent medical conditions, and medication interactions

This suggests that non-responders were less severely affected by ME/CFS at baseline, and that the main positive effect of nasal B12 administration occurs in more severely affected patients

Dietary lack Strict vegans who consume no animal products whatsoever can become deficient over time, as plant-based foods are not a reliable source of active B12