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The rationale was that direct delivery to the joint would maximize local efficacy while minimizing systemic exposure
In elder patients with Cyanocobalamin , the effect on the nervous system and the spinal cord is more severe
NNMT upregulation also elevates homocysteine levels, activating pro-inflammatory and pro-oxidative cascades (TLR4-NF-B and STAT3-IL-1 pathways) linked to atherosclerosis, heart failure, and coronary heart disease
Learn more about what can cause a B12 deficiency and how this can present
