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Journal of Skin Research, 3(2), 44-50

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That means: Hypokalemia can develop or worsen which can lead to: Cardiac arrhythmias Muscle weakness QT prolongation In severe cases, sudden cardiovascular instability This is a classic board-style pearl that many clinicians forget because B12 feels benign. But in profoundly deficient patientsespecially those with severe megaloblastic anemiarepletion is metabolically active treatment

This is important because rapid IV administration can lead to sudden shifts in electrolytes particularly potassium which may result in hypokalemia and, in severe cases, cardiac complications