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Importantly, persistently high serum B12 in the absence of supplementation should prompt GP assessment, as it may indicate underlying disease processes

[62] [63] The mechanism of action is straightforward: the hydroxycobalamin hydroxide ligand is displaced by the toxic cyanide ion, and the resulting non-toxic cyanocobalamin is excreted in urine

Serious and rarer side effects can include muscle cramping, irregular heartbeat, shortness of breath, slurred speech, vision changes, chest pain and weakness on one side of the body

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Some of the bodys cells create proteins that work like hormones, helping with processes like immune cell function, body growth and repair, and managing how we use energy