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[8] Although not an absolute contraindication, patients with coronary artery disease or unstable angina should only use B-Complex injections containing niacinamide under physician supervision, since high-dose niacin supplements have been linked to arrhythmias in such patients

Things that affect absorption: How well your body absorbs B12 from pills can vary

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A key study showed that this intervention improved insulin sensitivity in mice, suggesting it helps restore metabolic flexibility