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Blocking microglial activation of reactive astrocytes is neuroprotective in models of Alzheimer's disease

Caution is advised regarding the use of oral supplements in patients with pernicious anaemia, meaning that careful monitoring of symptoms would be required, and is not generally advised in patients with neurological symptoms, owing to limited efficacy and potentially serious impact of permanent neurological damage[25]

The jury is still out

While this is still a systemic approach, the absorption kinetics can be different from a subcutaneous shot

The answer is that these approaches are often complementary rather than competitive