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We do not use cyanocobalamin as it is a synthetic form

transitory exanthema Miscellaneous: Feeling of swelling of entire body Drug Interactions for Cyanocobalamin Persons taking most antibiotics, methotrexate and pyrimethamine invalidate folic acid and vitamin B 12 diagnostic blood assays

of course, ascertainment is difficult if the characteristic clinical dyad of hemolytic anemia and metabolic acidosis is not recognized and urine organic acid studies are not obtained

they can fall as much as 50 percent below optimal as we age

If fatigue is ongoing, unexplained, or affecting your quality of life, it may be worth exploring whether B12 deficiency is a contributing factor