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[27] Additionally, anyone with Lebers hereditary optic neuropathy (a rare inherited eye disease) must avoid cyanocobalamin injections, since B can precipitate rapid worsening of that condition

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This testing is added based on the criteria described above in When to test. In people without Down syndrome, studies have demonstrated that red blood cell folate and serum folate testing provide equivalent data

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Within body tissues, the specific B12 binding proteins transcobalamin I and II facilitate the absorption of cyanocobalamin into the cells.1017 Cyanocobalamin is a cofactor for the synthesis of two major enzymes in the body namely methionine synthase and L-methymalonyl-CoA mutase