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There is a similar beneficial effect in the rats with the Pringle maneuver, ischemia, reperfusion, and suprahepatic inferior caval vein occlusion (BuddChiari syndrome) (Vukojevic et al., 2018

Long term administration of agonists could potentially lead to unanticipated consequences in these organs

Nascobal - Clinical Pharmacology 12.1 Nascobal Mechanism of Action Vitamin B12 can be converted to coenzyme B12 in tissues, and as such is essential for conversion of methylmalonate to succinate and synthesis of methionine from homocysteine, a reaction which also requires folate

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