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Cyanocobalamin poses additional risks to smokers, and to individuals with methylation, liver or kidney issues, as these conditions can make it difficult to eliminate cyanide

This adverse effect has not yet been clinically reported Hypopigmented patches, especially on sun-exposed areas have been observed after 1012 doses of intravenous injection by practitioners (unpublished observations)

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Brands like NIOD utilize a high-purity, multi-copper complex to maximize this effect, while The Ordinary offers a more accessible version with a lower concentration