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Conclusion The high prevalence of vitamin B12 deficiencies in the elderly and increasing evidence that that low maternal vitamin B12 status in pregnant women may be a risk factor in birth defects has stimulated interest in considering the potential benefits of mandatory fortification of enriched flour with vitamin B12 [6 • ] No adverse effects are known to be associated with excess vitamin B12 intake from food or supplements in healthy individuals, except for individuals at risk for hereditary Leber’s optic atrophy disease who should not be exposed to cyanocobalamin because of a reduced capacity to detoxify the cyanide that is liberated in the cell [11]