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For example, cyanocobalamin can be risky for people with a condition called Leber's disease, as it might harm the optic nerve

High folic acid intake can also mask symptoms of vitamin B12 deficiency

It is also assumed that cobalamin supplementation is necessary until the symptoms of deficiency disappear (in the case of dietary modification) or must be introduced permanently if the diet does not cover the daily requirement for vitamin B12, which is usually the case when following a vegan/vegetarian diet