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It should be avoided however if you are reactive to any of the ingredients

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[DOI] [PubMed] [Google Scholar] 115.Housby J.N., Cahill C.M., Chu B., Prevelige R., Bickford K., Stevenson M.A., Calderwood S.K

Hydroxocobalamin has a higher affinity to the TC II transport protein than cyanocobalamin, or adenosylcobalamin