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While cyanocobalamin has proved effective in preventing vitamin B12 deficiency, there is increasing evidence that the coenzyme B12 forms have a distinct advantage and better spectrum of action in many specialised applications

Pushing past these limits does not accelerate results and may cause metabolic adaptation

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Microbiota modulate sympathetic neurons via a gut-brain circuit (in Eng)

If the patient is critically ill, or has neurologic disease, an infectious disease or hyperthyroidism, considerably higher doses may be indicated