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This balance between size and specificity is frequently cited as a design achievement of the original Monash research program and is one reason the molecule has endured as a reference compound across multiple laboratories
Any excessive amount not used by the body is flushed out in the urine due to vitamin B12 being a water soluble vitamin
If the cause isn't dietary then it is an absorption problem so you need to find another way of replenishing B12 initially
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