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Other visceral changes develop, which characteristically include organ changes caused by vascular deficiencies of the lung and liver

These signs overlap with the symptoms of pernicious anemia, because PA is a form of B12 deficiency

Pre-existing conditions such as liver disease, kidney problems, or known allergies can increase the risk of adverse reactions

The cyano prefix refers to the cyanide group attached to the cobalt center of the molecule, which sounds alarming but is present in such trace amounts that it poses no toxicity concern when used at standard supplemental doses

EKG: Sinus Tachycardia, otherwise normal Urinalysis: Specific Gravity 1.010