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High doses of B6 (600 mg daily) reduced prolactin levels by 68.1% in men with elevated prolactin, beating out the prescription drug aripiprazole which only managed 37.4% [12]

Common causes include: Pernicious anemia, an autoimmune disorder hindering Vitamin B12 absorption Gastrointestinal surgeries, like gastrectomy, impact Vitamin B12 uptake Long-term use of certain medications, such as metformin or proton pump inhibitors Diets lacking in Vitamin B12, often seen in vegans and vegetarians For those without a deficiency, Vitamin B12 injections are not typically recommended, as their body can naturally regulate and excrete excess amounts of the vitamin

For those following vegan or vegetarian diets, fortified foods or supplements become essential sources of B12

Nicotinamide (niacinamide) does not cause flushing and has fewer side effects, with nausea and liver toxicity reported only at very high intakes ~3 g/day)

this is a maximum hypersensitivity reaction of the immune system with varying degrees of severity, but which can be acutely life-threatening (Bilwani et al., 2005)