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Another source of toxicity of herbal medicines that is important to mention is adulteration of herbal products with undeclared pharmaceutical drugs and potentially toxic compounds such as harmful molecules present in other adulterating botanicals, pathogenic microorganisms, toxins, pesticides, agrochemical residues, and heavy metals (e.g., lead, mercury, and arsenic) (Saper et al., 2004

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Taste, degradation, and absorption variability

Cyanocobalamin specifically appears in most formulations rather than methylcobalamin, adenosylcobalamin, or hydroxocobalamin

This alteration results in the accumulation of toxic metabolites that can adversely affect renal function ( Table 1 ) [84, 85]