Vitamin B12 is a water-soluble vitamin that the body needs for various tasks ranging from red blood cell production and DNA synthesis to proper nerve function [1]. A high homocysteine level (15 umol/L) suggests vitamin B12 deficiency [2]. An elevated homocysteine level is associated with an increased risk of cardiovascular disease [3, 4]. There are also positive associations between elevated homocysteine levels and the incidence of both Alzheimer’s disease and dementia [5, 6].

Cyanocobalamin is the best way to deliver B12. Cyanocobalamin is a form of vitamin B12 approved by the FDA to treat vitamin deficiencies. Multiple researchers reported the efficacy of cyanocobalamin in treating pernicious anemia, a chronic illness caused by impaired absorption of vitamin B12 [8, 9]. Essentially, all clinical studies used cyanocobalamin, not methylcobalamin, to solve vitamin B12 deficiencies without showing toxic effects [10, 11].

The recommended daily intake of Vitamin B12 is 2-3 micrograms, but supplements can contain up to a couple of thousand micrograms because B12 is poorly absorbed from the gut. Even at the highest doses, the amount of cyanide released is about 20-40 micrograms, which is far less than the amount of naturally occurring cyanide to which one could be exposed by consuming flax seeds, unpasteurized almond milk, fresh apple juice, or apricots.