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Cyanocobalamin is the most widely available synthetic form, is shelf-stable, and is FDA-approved for treating B12 deficiency

Regular measurement of hematologic parameters is recommended in all patients on chronic metformin treatment

NNMT (Nicotinamide N-methyltransferase) is an enzyme that adds a methyl group to nicotinamide (a form of vitamin B3)

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However, once diagnosed it presents a difficult management problem in patients suffering from pernicious anemia, as there is no substitute