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Whilst vitamin B12 toxicity is exceptionally rare due to its water-soluble nature, very high levelsparticularly from mega-dose supplements or frequent injectionshave been associated with certain adverse effects, most notably skin reactions

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Gynecomastia cause maybe due to the following: Hormonal imbalance, where testosterone levels decline relative to oestrogen, often seen during puberty, ageing, or hormonal disorders Side effects of medications such as anabolic steroids, antibiotics, corticosteroids, opioids, antidepressants, anti-anxiety drugs, and heartburn medications Underlying medical conditions including chronic kidney failure, hyperthyroidism, liver cirrhosis, obesity, and low testosterone Use of recreational substances such as marijuana or alcohol abuse, which can disrupt hormone balance What are the symptoms of gynecomastia

Substrate availability can also regulate TCA flux