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Delayed gastric emptying extends the time B12 spends in the acidic stomach environment, which might initially seem beneficial

Side Effects and Safety Side effects Across preclinical studies and the small human trials published to date (~28 subjects across pilot studies), the reported adverse events stay limited: Mild injection-site irritation (rare) No systemic toxicity at therapeutic doses in published reports Oral administration: mild GI upset in sensitive individuals No immunosuppression, hormonal disruption, or metabolic side effects have been observed

Unfortunately, the compounds suffer from poor in vitro metabolic stability (Engen et al., 2020)

Nausea (41%), diarrhea (23%), vomiting (20%), and constipation (18%) are the most frequently reported