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First, a 1,000 g dose of cyanocobalamin provides only 19.2 g of cyanide, a trivial addition to the 113 to 164 g already ingested daily from food and air

It is also important to note that the Food and Drug Administration (FDA) may not have approved all of these uses, so a thorough risk-benefit assessment should be undertaken by the prescriber

But like any medical treatment, they come with both benefits and risks

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This paradoxical reaction is not fully understood but is thought to be related to individual metabolic responses