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In each case, there was another specialty which was reported more than twice as often in the claims data as the specialty suggested by commenters and in some cases reported as much as twenty times as often

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Yet the consequences are unknown Bioavailability: there are four specific metabolic steps necessary to convert cyanocobalamin into one of the coenzyme forms, which is a clear metabolic disadvantage (3) Utilisation problems: certain hereditary diseases, as well as metabolic disorders, prevent the conversion of cyanocoalamin into the active B12 forms (4) Steals methyl groups: cyanocobalamin requires a methyl group to convert into methylcobalamin, which it takes from the important amino acid S-adenosylmethionine (SAM)