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It must be converted to methylcobalamin or adenosylcobalamin in the body before it can be used, releasing a small amount of cyanide in the process (at non-toxic levels)

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If concentrations of serum vitamin B12 are above the reference range and people have no specific medical conditions, the panelists agreed that inquiring about the usage of supplemental vitamin B12, repeating the measurements of serum B12 after a given time interval, and measuring routine blood markers of renal or liver function or exploring malignancies [91] could explain the cause of high serum B12 (Table 1)

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