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Doubling daily KLOW intake (5 mg instead of 2.5 mg) produces stronger receptor downregulation without proportional metabolic benefit and may trigger transient side effects elevated heart rate, jitteriness, or sleep disruption if the double dose occurred in the evening

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10.7150/ijms.61080 137 YangC.-Y.Cheng-Yen LaiJ.HuangW.-L.HsuC.-L.ChenS.-J

Analyst 142 , 44314437 (2017)

As a general strategy to avoid vitamin B12 acne, it is advisable to take oral supplements (as oppose to injections) and to control the intake of the cofactors folate and biotin