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According to a 2007 study in the British Journal of Nutrition , the minute levels of cyanide from Cyanocobalamin are harmless, especially when compared to natural sources of cyanide in foods like almonds and spinach foods that are commonly consumed without issue (Diabetes Journals)

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"Clinicians should ask patients about all dietary supplements at every visit, as over-the-counter products containing vitamin B6 in doses exceeding the Tolerable Upper Intake Level are widely available and may confound the diagnosis of diabetic peripheral neuropathy." Per the NIH Office of Dietary Supplements, the tolerable upper limit for vitamin B6 in adults is 100 mg per day [6]