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In addition, there is a higher intensity of CD38 expression (measured by flow cytometry) in the more aggressive multi-hit variants, which allows further differentiation of the diseases and the use of CD38 as a biomarker for early diagnosis [14]

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Methylcobalamin is the most expensive form of B12 however is favoured by Dr Knight due to its effectiveness with patients remotely and in clinic

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Despite low CNS penetration, some studies report detectable levels in the brain, supporting its potential for systemic biological effects without significant accumulation (Jzwiak et al