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Other: muscle cramps and weakness, decreased sexual performance and sialadenitis

[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

Why This Perspective Matters Clinically This Ayurvedic interpretation offers patients something important that many feel is missing in conventional care: a full-body explanation