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Sometimes it is not

How about handling the medication with more care

Shen XY, Tang CC, Jan JS

This particular form represents the most reduced and chemically reactive state of cobalamin, rendering it highly receptive to binding a methyl group from a form of vitamin B9 called 5-methyltetrahydrofolate, the product of methylenetetrahydrofolate reductase (MTHFR), to generate methylcobalamin (MeCbl)