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Over time, repeated clinic visits can easily mean thousands of dollars a month for those on a daily injection protocol

48 , 113 Cyanocobalamin must be broken down to cobalamin and cyanide must be converted to the active forms of B 12 in the human body, whereas genetic single nucleotide polymorphisms can interfere in the metabolism and conversion to intracellular active forms of vitamin B 12

We are the control group, it seems

Nature 562, 578582 (2018)

But that doesnt mean serious side effects never happen

Mechanism of Action in Laboratory Research Modulation of intracellular signaling pathways Enhancement of growth factor sensitivity in research models Regulation of gene expression patterns Influence on mitochondrial ATP production and energy metabolism Support of enzymatic activation and pathway mapping studies Primary Research Applications Metabolic Signaling Research: Investigating intracellular signaling cascades related to metabolic regulation