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Your doctor can do a blood test if youre concerned

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[21] Within cells, cyanocobalamin is converted to methylcobalamin and 5- deoxyadenosylcobalamin, coenzymes that participate respectively in homocysteine remethylation to methionine and in the isomerization of methylmalonyl-CoA to succinyl CoA, reactions essential for DNA synthesis, erythropoiesis, and myelin maintenance

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AOD-9604 does not affect the hypothalamic-pituitary axis, so there is no negative feedback loop to blunt the response over time