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Niacin ameliorates oxidative stress, inflammation, proteinuria, and hypertension in rats with chronic renal failure

Although further study of these interactions is necessary, patients receiving these agents concurrently should be monitored for the desired therapeutic response to vitamin B12

Common B12 deficiency symptoms include fatigue, anxiety, depression, poor memory, confusion, brain fog, tingling or numbness in the extremities, zings or zapping feelings in the extremities, anemia, shortness of breath, muscle weakness, irritability, tender calves, pale complexion and more

10.1038/s41598-018-26956-7 87 LiuM.LiL.ChuJ.ZhuB.ZhangQ.YinX.et al (2015)

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Nicotinamide N-methyltransferase: At the crossroads between cellular metabolism and epigenetic regulation