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Patients with polycythemia vera a blood disorder involving overproduction of red blood cells face additional risks since B12 stimulates red blood cell production

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Wipe the stopper with an alcohol swab before every draw

One study, which also evaluated cognitive function in patients with high MMA concentrations, found no significant effects on the MDD inventory score, but only 30 of the 140 subjects had depression at baseline, which may have diluted any benefits