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Or having a mutation become active that raises B12

A 1mg dose of cyanocobalamin releases approximately 20 micrograms of cyanide

Those with pre-existing deficiency, dietary restrictions, absorption issues, or multiple risk factors benefit from either adding b12 to their compounded semaglutide or taking it separately

But this hasnt been proven in clinical research, and there are no studies or case study reports linking biotin supplements to acne, (at this moment in time)