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A mistake that is sometimes made is stopping treatment because of the worsening symptoms, but when B12 has been diagnosed that actually is the wrong route to take

Early intervention (within days to weeks) potentially preventing progression to osteoarthritis

The agency notes specific risks too

Arylacetamide deacetylase attenuates fatty-acid-induced triacylglycerol accumulation in rat hepatoma cells

Third, hyperhomocysteinemia detected both under basal conditions and after a methionine challenge (approximately 50% of patients), which might be partially explained by a saturation of the transsulfuration pathway caused by dietary methionine excess

Competitive athletes subject to testing should not use peptides containing them