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The CKD code must be sequenced first per ICD-10-CM Official Guidelines Section I.C.14

[9] The most significant side effect of excessive pyridoxine exposure is peripheral neuropathy affecting sensory nerve function

Oral supplements must pass through the digestive system and liver, which can reduce the amount reaching your cells by 50% or more

alkylation of a C3-amino-quinoline derived precursor, such as compound 8 may be achieved via reductive amination with, for example, triethyl orthoformate in TFA followed by treatment with NaBH 4 to give the corresponding secondary C3-amine derivative (such as N-methyl-C3-amino-quinoline 9)

In fact, studies show that B12 deficiency is one of the leading nutrient deficiencies in the world, and is also a major health concern in many parts of the world, including the US, Mexico, Central and South America