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This creates an interesting mechanistic distinction

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Concurrent iron-deficiency anemia and folic acid deficiency may result in a blunted or impeded response to cyanocobalamin therapy.1

Methionine, inositol, and choline are nutritional compounds involved in separate biochemical pathways from incretin receptor signaling

[5] By simultaneously providing all these B vitamins, the injection ensures that the body has all necessary co-factors in adequate supply

PMID 18843658