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Except for some unusual findings for lung cancer discussed below, associations between elevated serum B12 and increased disease or mortality are most plausibly explained by reverse causation, in which underlying disease raises B12 levels rather than elevated B12 causing disease

Elevations in blood pressure (180 mmHg systolic or 110 mmHg diastolic) were observed in approximately 18% of healthy subjects (not exposed to cyanide) receiving hydroxocobalamin 5 g and 28% of subjects receiving 10 g

This genetic metabolic block severely impairs the body's ability to produce cellular energy and clear out neurotoxins, directly contributing to the hallmark symptoms of ME/CFS, including profound post-exertional malaise (PEM) and unrefreshing sleep

And, if you remember, reverse causation is when X may not lead to Y, but, instead, Y may lead to X