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Shaking can cause mechanical stress that damages the delicate peptide chains, potentially denaturing them and rendering them ineffective

Severe megaloblastic anemia: Vitamin deficiency and other causes. Cleveland Clinic journal of medicine vol

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Pre-Existing Conditions Use caution if you have a history of cardiovascular disease, diabetes, or hormone-related conditions

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For use in vitamin B12 deficiency associated with cobalt deficiency in cattle and sheep and for vitamin B12 deficiency associated with inadequate vitamin B12 intake or intestinal malbsorption in swine and horses.