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These reactions are typically the result of taking high doses of a supplement, according to Mayo Clinic

Dietary deficiency can usually be corrected with oral supplements or diet changes

They mentioned weakness on one side, nightmares, dizziness, anxiety, insomnia, restlessness, numbness, nausea, muscle spasms, tingling, itching, acne, psoriasis, eczema, heart palpitations, leg cramps, blurred vision, hair loss, and not being able to concentrate or to stand noise

Hydroxocobalamin - Clinical Pharmacology Vitamin B12 is essential to growth, cell reproduction, hematopoiesis, nucleoprotein and myelin synthesis

The mechanisms, dosing, and effects are the same

The donor responsible for the decyanation seems to be glutathione, which PA patients need for lowering their increasing levels of homocysteine