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While cyanocobalamin can still raise blood levels, it may not act as quickly or effectively in neurological tissue
High-pressure water hitting the lyophilized cake denatures peptide chains
In UK practice, monitoring is primarily based on clinical response rather than routine blood tests, as post-treatment serum B12 measurements can be misleadingly high and may not reflect tissue levels
Gel formulations of vitamin B12 are somewhat new and applied into the nostrils (intranasally)
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