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When vitamin B12 levels are optimal, it can boost energy levels

[1] Persistently high B12 levels warrant medical investigation, as they may signal liver disease, kidney dysfunction, or certain haematological disorders

In any case, it appears that the base-exchange reaction operates in vivo when excess nicotinamide analogs are available to tissues (Figure 2) (37)

Chen L, Diao L, Yang Y, Yi X, Rodriguez BL, Li Y, et al

Both serum potassium concentrations and the platelet count need to be monitored carefully after parenteral administration of cyanocobalamin
