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In addition corticosteroids have been associated with local skin atrophy, depigmentation and muscle wasting, resulting in an increase in the bony prominence of the medial epicondyle

Empower has been the subject of four warning letters and a less severe untitled letter from the FDA going back to 2017, and its pharmacy license was placed on probation in 2023 by the California State Board of Pharmacy, which accused Empower of distributing adulterated or inferior vitamin injections

Vitamin B-12 status in infancy is positively associated with development and cognitive functioning 5 y later in Nepalese children