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For example, those with pernicious anemia or poor vitamin B12 absorption need a treatment plan that fits their needs

Fibroblast and cell-response studies

The deregulation of TET enzymes also affects the pluripotency and differentiation of embryonic stem cells, with oncogenic signaling interfering with lineage-specific differentiation programs (135)

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However, if the underlying cause of your deficiency remains such as pernicious anemia or ongoing medication use that impairs absorption your B12 levels will gradually decline after discontinuation

The combination approach appears most promising for long-term sustainability