However, it is best to avoid treatments consistently under 12 weeks when possible because there may be some risk of antibody formation against Botox which can make it less effective over time
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Caution is advised in patients with Leber optic atrophy, a genetic disorder caused by chronic cyanide intoxication (such as from smoking, alcohol or some plants), against the use of cyano-B12 due to its cyanide moiety, whilst hydroxo-B12 is a cyanide antagonist and can therefore be used in these patients
This typically follows confirmed diagnosis of B12 deficiency through blood tests and clinical assessment