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10.1146/annurev-physiol-042022-031925 35 XianX.XuM.YuH.WangL.LiX.RakJ.et al (2021)

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Summary: True vitamin B12 overdose is exceptionally rare because it is water-soluble and excess amounts are excreted through urine rather than accumulating in body tissues

however, unlike nicotinic acid, niacinamide does not usually cause the intense flushing reaction (redness/itching) of the skin

Then the glutathione becomes depleted and we can no longer protect ourselves against free radicals, infections, or cancer and we cant get rid of toxins

In turn, a driver monitoring system could detect this and enact countermeasures to improve road safety