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The use of hydroxocobalamin became first line due to its low adverse risk profile, rapid onset of action, and ease of use in the prehospital setting
PubMed Central, Konijeti, Gauree G., et al
The increase in circulating cobalamin levels is predominantly caused by enhanced production of haptocorrin.Several liver diseases like acute hepatitis, cirrhosis, hepatocellular carcinoma and metastatic liver disease can also be accompanied by an increase in circulating cobalamin
Too acidic and the copper dissociates
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