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For example, cyanocobalamin can be risky for people with a condition called Leber's disease, as it might harm the optic nerve

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[3] It is examined for its role in peptide-metal interactions, redox signaling, and metalloproteinase regulation

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The reason for the higher prevalence in this patient population is not clear, but could arise from the fact that the patients were selected for the presence of neuropathic symptoms that involved the feet, which could contribute to a poor performance on a walk test due to sensory deficits and pain