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The problem of excess B12 started in the last decade with the availability of highly efficient oral and injectable forms of B12

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Nutrients 3 , 118134 (2011)

B12 (cobalamin) is a water-soluble vitamin essential for neurological function, red blood cell formation, and DNA synthesis Joint pain is not listed as a recognised adverse effect in the BNF or licensed B12 product information When joint discomfort occurs after starting B12, it is typically coincidental or related to excipients, injection technique, or pre-existing conditions Severe B12 deficiency itself can cause neuropathic symptoms that may be misinterpreted as joint pain Do not discontinue prescribed B12 treatment without medical guidance, particularly for confirmed deficiency or pernicious anaemia Seek prompt medical advice for severe joint pain, hot swollen joints with fever, or symptoms of allergic reaction Table of Contents Can Vitamin B12 Cause Joint Pain

It makes it an adjunct with a plausible mechanism and thin outcome data, delivered inside a supervised programme