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Doctors watch how the body responds to adjust the treatment

The 2025 meta-analysis by Alfalasi and colleagues, published via PMC, synthesized data from 16 studies and 6,098 total participants

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Safety & Contraindications Not FDA-approved

Furthermore, co-administration of arginine with potassium-sparing diuretics (e.g., spironolactone, amiloride) is cautioned, as both can increase serum potassium levels and together may precipitate hyperkalemia (high potassium), which in turn may lead to dangerous heart arrhythmias

In humans, cyanocobalamin must undergo intracellular enzymatic conversion to the active coenzyme formsmethylcobalamin and adenosylcobalaminwhich, depending on the pH environment, can interconvert with hydroxocobalamin (Obeid et al., 2015)