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[2] However, elevated MMA is not conclusive, as it is seen in people with B 12 deficiency, but also in elderly people who have renal insufficiency, [28] and elevated homocysteine is not conclusive, as it is also seen in people with folate deficiency
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That longer action is part of why maintenance injections can be spaced months apart rather than weeks
The primary practical consideration is selecting a suitable bacteriostatic agent
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