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Though rare, they can be serious if ignored

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Electrolyte Disruptions : Your heart's electrical system depends on a precise balance of minerals

[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

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