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When administered orally in mouse models of colitis, KPV significantly decreased colon inflammation and improved disease severity

This is why medical screening before use matters

That basically means it is less likely to wipe out your gut flora to the extent that other antibiotics like Neomycin might

Summary: Excessive vitamin B12 intake rarely causes toxicity, but very high levels from supplements or injections may be associated with skin reactions such as acne-like eruptions, though serious adverse effects remain exceptionally uncommon