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Since vitamin B12 is a water-soluble vitamin and any excess that isnt used is flushed from the body the risk is minimized

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NNMT Inhibition Mechanism and Optimal Dosing Range 5-Amino-1MQ functions as a small-molecule competitive inhibitor of nicotinamide N-methyltransferase (NNMT), the enzyme responsible for methylating nicotinamide

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The depletion of glutathione (an antioxidant needed to remove the cyanide from cyano B12) may increase homocysteine, thus only making things worse for these patients