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One nuance worth knowing: increased polyamine flux was actually framed as part of the benefit in the original obesity work, because cycling polyamines through synthesis and breakdown burns energy

doi:10.1016/0002-9343(94)90149-x

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For Severe Deficiency and Medical Conditions : Hydroxocobalamin injections are preferred, especially if you need long-lasting effects or have absorption issues

This is important because some individuals, especially those with specific health conditions (like genetic mutations or absorption issues), may have difficulty metabolizing regular B12