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In the blood stream as nicotinic acid, it can cause skin flush and this reaction is actually responsible for the tolerable upper limit (UL) for niacin at 35 mg/d for adults in US (20)

Unlike fat-soluble vitamins (A, D, E, and K), which are stored in fat tissue for long periods, water-soluble vitamins are processed relatively quickly: your body takes what it needs, stores a small amount in the liver, and passes most of the rest in urine

It reduces appetite, helps control cravings, and increases calorie burn by modulating neurotransmitters in the brain

Amyotrophic lateral sclerosis (ALS) : Methylcobalamin may treat ALS symptoms by decreasing homocysteine levels, a neurotoxic amino acid