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While a blood test is the definitive way to diagnose a clinical deficiency, it isnt always required to start B12 injections for general wellness purposes

Journal of Manufacturing Processes, 56 , 12191229

It demonstrates significant anti-inflammatory properties through reduction of pro-inflammatory cytokines including TNF-alpha, IL-1 beta, and IL-6

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[5] Vitamin B 12 is an essential nutrient meaning that it cannot be made by the body but is required for life