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PLoS One (2012) 7:e36989

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In this cycle, it serves as a cofactor to allow conversion, so a deficiency of B12 or folate can interfere with the conversion and lead to a buildup of homocysteine 1

Research from the NCBI explains that those with severe deficiencies or trouble absorbing B12 might need regular doses to keep their levels steady

This dramatically helps to quantify the improvement during treatment, in this situation, twice-weekly intramuscular injections of hydroxocobalamin, and it also identified which symptoms probably were unrelated to the deficiency