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However, it is undeniable that correction of moderate to severe Se deficiency has a positive impact on the prophylaxis of GD

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Because the two act through separate pathways, they are sometimes discussed together, but "different mechanisms" is not the same as "proven to work better together." Mechanistic plausibility is a hypothesis, not evidence of a benefit or of safety in combination

Please also see PATIENT INFORMATION Overdose Information for Nascobal No overdosage has been reported with Nascobal Nasal Spray, Nascobal (Cyanocobalamin, USP) Gel for Intranasal Administration or parenteral vitamin B 12