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Oral niacinamide supplements (250-500 mg daily) are safe and well-tolerated for most people

Conditions where the bone marrow overproduces blood cells, including polycythemia vera, chronic myeloid leukemia (CML), and hypereosinophilic syndrome , can cause elevated B12 levels

Common side effects may include nausea, vomiting, or mild gastrointestinal issues, which usually improve over time as your body adjusts to the medication

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