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Do not use in pets with hypersensitivity to hydroxocobalamin

Moreover, chronic or prolonged supplementation with ALA after the cessation of stress stimuli may not provide additional metabolic or anti-oxidative benefits, and in some cases, may partially associated with histopathological changes in liver or induce pro-oxidant effects under normal physiological conditions (5052)

The most common reason someone would need to have their vitamin B12 levels checked is to evaluate for vitamin B12 deficiency, says Mike Ren, MD, assistant professor of family and community medicine at Baylor College of Medicine

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Those with active malignancy, certain pituitary issues, or poorly controlled diabetes may not be appropriate and require careful medical evaluation first