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[16] Although cyanocobalamin lacks a defined upper-toxicity threshold due to its water solubility and renal elimination, exceptionally high cumulative doses have been temporally associated with acneiform eruptions, altered potassium homeostasis, and theoretical thrombotic risk, emphasizing the importance of evidence-based dosing

KARGER, Basel, pp 121134 Motiwala SR, Szymonifka J, Belcher A et al (2014) Measurement of novel biomarkers to predict chronic heart failure outcomes and left ventricular remodeling

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