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Anyone pregnant, breastfeeding, with known methylation disorders (e.g., MTHFR variants causing homocysteine issues), liver or kidney disease, or taking drugs relying on SAM-dependent pathways should avoid it until human safety data exist
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According to NICE Clinical Knowledge Summaries, B12 supplementation for confirmed deficiency should follow established protocols, but routine monitoring of B12 levels after treatment initiation is not always necessary unless clinical response is inadequate
12 solution to be administered through injection only Intended for use in cattle