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How the condition is evaluated and managed Clinicians typically confirm B12 status with blood work serum B12, and often methylmalonic acid (MMA) and homocysteine, which rise when B12 is functionally low

If excessive foam persists for more than 10 minutes, you likely injected the water too forcefully or shook the vial

Safety and effectiveness in pediatric patients have not been established

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The agitation breaks the weak bonds holding the protein in its active shape