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While RCTs remain the gold standard for intervention assessment, observational studies provide complementary evidence, especially when using objective biomarkers such as serum Vitamin B12, MMA, and homocysteine
73% bioavailability via subcutaneous injection
This means vegetarians and vegans may be at risk of having low levels of B12
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Concomitant deficiencies (iron, folate), chronic illness, or drug interactions may blunt clinical response and warrant further evaluation
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