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[21] When treated with cyanocobalamin, patients with Leber's disease may develop serious optic atrophy, possibly leading to blindness, based on few case reports

What's more concerning is that its often overlooked, especially if a standard blood test shows "normal" B12 levels but more sensitive markers like homocysteine aren't checked

Medically reviewed by Faisal Shafiq (Superintendent Pharmacist, GPhC registration number 2067224)

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In laboratory research, administering 5-Amino-1MQ competitively inhibits NNMT activity, halting the clearance of nicotinamide