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Deficiency causes megaloblastic anemia abnormally large, dysfunctional red cells that impair oxygen delivery, producing fatigue, shortness of breath, and pallor

Hydroxocobalamin and cyanocobalamin are both forms of Vitamin B12, but hydroxocobalamin stays in the body longer

[13] Chloramphenicol has been shown to blunt reticulocyte response to cyanocobalamin, while ethanol, colchicine, and nitrous oxide interfere with cobalamin metabolism or utilization, each warranting clinician awareness when evaluating suboptimal treatment outcomes

Hemochromatosis: Patients with this condition have an increased absorption of iron