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For severe cases or when conservative measures fail, surgical options may become necessary
When stratified by administration route, the mean percentage changes were: Intramuscular (IM): 307% Oral: 285% Sublingual: 199% IM administration showed the highest average B12 increase, although oral and sublingual routes also yielded substantial improvements, supporting their use as effective and less invasive alternatives
Individuals with methylation issues, such as those with MTHFR variants, might respond differently to NNMT inhibition
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