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The reason for pairing them is to support skin remodeling during rapid weight loss, but no controlled trial has tested the combination or shown that effect

However, the levels of cyanide resulting from cyanocobalamin are so minimal that the term toxic is hardly applicable here Build up in the cells: studies have shown that around 1000 g of cyanocobalamin accumulates in the cell fluid during therapy with high dosages (2)

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This is where the work of organizations like the Pernicious Anaemia Society is so important in bridging that gap and advocating for a more empathetic, scientifically-grounded, and flexible approach to patient care