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Without adequate methylcobalamin, this entire engine grinds to a halt, leading to a cascade of cellular failures that manifest as profound fatigue and cognitive decline
Injections may also be recommended for those who have had bariatric surgery or other conditions affecting digestion
In addition to excessive intake of dietary supplements, parenteral administration of vitamin B12 may be another cause of excess, which is likely associated with an immune system response to produce anti-TC II antibodies
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