[1] [3] The injection bypasses the gastrointestinal tract entirely, making it particularly effective for patients with absorption problems such as pernicious anaemia or those who have undergone gastric surgery
Part of the solution is to use methylated B12 and folate, rather than folic acid
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"Nicotinamide N-methyltransferase inhibition mimics and boosts exercise-mediated improvements in muscle function in aged mice." Scientific Reports