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Cyanocobalamin can also be prescribed to treat pernicious anemia, a condition where the body is unable to absorb sufficient amounts of vitamin B12 from food

Firstly a few principles

It is not listed on the 503B compounding bulk substances list (per FDA Warning Letter, Jan 2026)

Another potential mechanism of action for the pain-reducing properties of vitamin B12 comes from interactions with prostaglandin synthesis, including cyclooxygenase (COX) enzymes