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No adverse fetal effects have been documented from normal therapeutic doses of hydroxocobalamin in human pregnancies

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[23] Increased longitudinal cohort studies or randomised controlled trials are required to understand the mechanisms between vitamin B 12 and metabolic outcomes, and to potentially offer interventions to improve maternal and offspring health

Always consult with your healthcare provider before starting any new supplement, especially if you have genetic mutations like MTHFR or COMT, or if you are taking medications that may interact with B12 absorption