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Many people with B12 deficiency or pernicious anemia naturally lack sufficient detoxifying methyl donors, and have trouble clearing out the cyanide

Vitamin B12 deficiency and hemolytic anemia presenting as pseudo thrombotic microangiopathy: A systematic review

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For those who are deficient, it may be necessary to supplement the diet with B12

Journal of Physiology Paris 93:501504 Radeljak S, Seiwerth S, Sikiric P (2004) BPC 157 inhibits cell growth and VEGF signalling via the MAPK kinase pathway in the human melanoma cell line

Development of new phosphated cellulose for application as an efficient biomaterial for the incorporation/release of amitriptyline