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Cyanocobalamin needs to be changed into active forms, while methylcobalamin is ready to use right away
But peer review is a separate process for scientific studies, whether they are RCTs or not

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many are marketed under familiar drug names but sold as "research-grade" products meant for laboratory use, not human treatment, and their ingredients, strength, and sterility can vary or be contaminated and mislabeled (goodrx.com)
