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In November 2025, the Trump administration announced it had negotiated a significant price drop for Medicare and Medicaid enrollees

This condition can be either primary (genetic) or secondary (resulting from other health conditions such as kidney disease)

However, some patients receiving high-dose B12 supplementation or injections may experience adverse reactions, though these relate to the treatment rather than the elevated levels: Possible reactions to B12 supplementation (particularly injections): Skin reactions, including acneiform eruptions or rashes Pruritus (itching) Injection site reactions (with parenteral administration) Rare hypersensitivity reactions Non-specific symptoms such as headaches, dizziness, or gastrointestinal disturbances have been reported by some patients taking B12 supplements, but causality is not well established in clinical evidence

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