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Overdose Overdose can occur only after the administration of extremely large doses for a long period

This was because hydroxocobalamin produced by bacteria was changed to cyanocobalamin during purification in activated charcoal columns after separation from the bacterial cultures (because cyanide is naturally present in activated charcoal)

The low incidences of vitamin B12 deficiency and the reduced need for replacement after PG-DTR in this study align with the results of the KLASS-05 randomized controlled trial (RCT) and meta-analysis [3,5]