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One of these issues is the fact that GLP-1 and GIP are only two of the many known substrates for DPP4 cleavage

1,2 Serum vitamin B 12 levels may be artificially elevated in patients with alcoholism, liver disease, or cancer because of decreased hepatic clearance of transport proteins and resultant higher circulating levels of vitamin B 12

It's important to note that these side effects are uncommon, and most people tolerate B12 Methylcobalamin Injections well

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Diabetes 59(4):10301037 Calzetta L, Matera MG, Cazzola M (2018) Pharmacological mechanisms leading to synergy in fixed-dose dual bronchodilator therapy