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Pumpo R, Sarnelli G, Spinella A, Budillon G, Cuomo R (2001) The metabolism of nicotinamide in human liver cirrhosis: a study on N -methylnicotinamide and 2-pyridone-5-carboxamide production

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I have also had similar symptoms on a couple of occasions and it is normally after a long period without B12 and then a going back on it too quickly