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Factors such as initial B12 levels, underlying medical conditions, certain medications, advanced age, and injection frequency can affect the absorption and utilization of B12, possibly shortening the duration of action

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Neurol., 61, 111-124, 2002) leading to excess production of N-methylpyridinium ions in the brain that act as neurotoxins linked to the pathogenesis of neurodegeneration (See e.g., Herraiz T

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