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In vitamin B 12 deficiency, the mutase reaction is impaired, causing accumulation of D-methylmalonyl-CoA, which is converted to methylmalonic acid
High-fat meals slow it further, increasing the time food sits in the stomach and amplifying nausea, bloating, and reflux
Competing interests The authors declare no competing interests
This excellent safety record contributed to the peptides characterization as having tolerability indistinguishable from placebo in published research
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