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The leading explanation is amplification of a pain-signaling channel on skin sensory nerves (purinergic ATP/P2X signaling). Symptoms were usually mild and eased after dose reduction

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doi:10.3390/molecules191119066 Seiwerth S, Rucman R, Turkovic B, et al

The Sucrosomial B12 formulation possibly overcomes these obstacles by entrapping vitamin B12 within a protective matrix composed of phospholipids, primarily derived from sunflower lecithin, and a sucrester (sucrose ester)

If you have pre-cancerous cells you don't know about, BPC-157 could theoretically accelerate their growth

Much of the peptide can be destroyed before it ever reaches the intestines where it could be absorbed