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The durability of metabolic benefits after washout, the consequences of chronic pan-ERR activation in heart and kidney, and the potential for tolerance or compensatory network changes require longer studies

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Methylmalonic Acid (MMA) Test: High MMA levels suggest B12 deficiency, even if B12 levels are close to normal

Note: Some people have sickle cell beta-thalassemia (Hb S/B Th)

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It is preferred over cyanocobalamin due to its longer duration of action, better retention, and lower toxicity profile