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Synthetic Vitamin B12 injections consist of a synthetic version of the vitamin known as cyanocobalamin

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The first was transient thyrotoxicosis without TRAb, observed in 12 patients (2 treated with pembrolizumab, 10 with nivolumab), of whom 9 (2 treated with pembrolizumab, 7 with nivolumab) eventually developed hypothyroidism, suggesting destructive thyroiditis

Oral Surg Oral Med Oral Pathol 76:5961 Buchner A, Hansen LS (1979) Melanotic macule of the oral mucosa