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Amazon hasnt officially published a detailed explanation, but based on recent changes, a few clear reasons stand out

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People with the following should discuss risks carefully with a medical professional: Liver disease Kidney disease Pernicious anemia Known allergies to any ingredient in the formulation Pregnancy or breastfeeding (safety not well-studied avoid unless prescribed) Because ingredients differ between providers, always verify the formulation and follow prescribed dosing to minimize risk

doi:10.1016/j.neucli.2021.12.005

There should be little to no bleeding since the wound will be smaller than a mosquito bite

According to the NIH Office of Dietary Supplements, B12 plays a key role in: Making red blood cells and preventing megaloblastic anemia Maintaining healthy nerve function and the myelin sheath that protects nerves DNA synthesis Supporting brain function and preventing cognitive decline Converting food into energy (cellular metabolism) Because B12 is found almost exclusively in animal products meat, fish, dairy, and eggs certain groups of people are at much higher risk of deficiency than others