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The National Institutes of Health Office of Dietary Supplements has not set a Tolerable Upper Intake Level for B12 precisely because no reliable evidence of harm from high intakes has been established in healthy people

It carries a long disciplinary history across multiple state boards, including a Texas reprimand, a California revocation, and actions in Kentucky and Oklahoma, along with failure-to-disclose and failure-to-report violations

These symptoms require urgent evaluation with electrocardiography, cardiac biomarkers, and potential cardiac imaging to rule out myocardial infarction or unstable angina

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PMID: 19438432