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This is because methylcobalamin B12 acts on the bone marrow to normalize red blood cell formation

Cautious use of parenteral cyanocobalamin is also recommended in patients with renal impairment, including premature neonates, because of the possibility of greater aluminum accumulation, which may cause central nervous system and bone toxicity

It is a coenzyme your cells already make from vitamin B3, and it is central to two things: shuttling electrons through energy metabolism, and serving as a required cofactor for sirtuins, PARPs, and CD38