However, note that as cyanocobalamin is excreted more quickly, injections must be more frequent (monthly rather than every 3 months)
Cyanocobalamin is the most widely available synthetic form, is shelf-stable, and is FDA-approved for treating B12 deficiency
Side effects, particularly nausea, are more pronounced than single-agent therapy but manageable with proper strategies
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A tiny slip of the plunger can dramatically alter the dose
