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This effect is thought to be mediated through GLP-1 receptors in the cardiovascular system and is generally not clinically significant, though patients with certain arrhythmias or those sensitive to heart rate changes should be monitored

It may however take a few days or weeks (especially if addressing a B12 deficiency)

Sikiric, P., Drmic, D., Sever, M., Klicek, R., Blagaic, A., Tvrdei, A., Kralj, T., Kovac, K., Vukojevi, J., Siroglavi, M., Gojkovic, S., Krezic, I., Pavlov, K., Rasic, D., Mirkovic, I., Kokot, A., krti, A., & Seiwerth, S

Medical history: gallbladder disease, pancreatitis, kidney issues, or eating disorders change the risk discussion