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Yes, some patients experience temporary fatigue as their body adjusts to therapeutic B12 doses and metabolic processes reactivate

With regard to glutamine metabolism, inhibition of glutamine utilization has likewise been incorporated into the clinical development strategy of metabolic targeting plus immunotherapy. Animal studies have shown that JHU083, a prodrug of the glutamine antagonist 6-diazo-5-oxo-L-norleucine (DON), not only suppresses tumor growth, but also reshapes the transcriptional profile and antigen-presentation/inflammatory cytokine characteristics of tumor-associated macrophages, shifting them from an immunosuppressive tendency toward a functional state more favorable for antitumor immunity (118)

Smits RM, et al

To prioritize the safety of both mother and child, avoid use unless specifically advised by a healthcare professional