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In acquired B12 deficiency, both oral and IM routes have been featured in guidelines to replenish this compound in deficient states

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This substitution may increase the half-life of the peptide by protecting it from enzymatic cleavage and degradation

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In this study, the cB 12 quotient helped to establish that MMA is the most sensitive marker of vitamin B 12 in cancer patients, and that total serum B 12 has very little diagnostic value (Vashi et al., 2016)