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The lack of danger of an overdose is further underlined by the advice to treat patients with neurological involvement with two injections a week for up to two years, if necessary

However, once the benzimidazole is detached from cobalt by quaternization with methyl iodide, it is replaced by H 2 O or hydroxyl ions

Chemotherapy with drugs like 5-fluorouracil has also been associated with acute thiamine deficiency by disrupting thiamine activation, so oncology patients receiving such therapy might receive parenteral thiamine supplementation as part of this B-Complex if needed

This inhibition is likely to influence electrolyte balance in the mucosal layer and may diminish the efficacy of immunological components that are sensitive to pH alterations (Keszthelyi et al