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Patients taking insulin and engaging in extended periods of exercise should monitor their blood glucose levels before, during, and after the exercise period

Of the 40 patients (21%) who had baseline serum MMA levels, five had a serum B 12 250 pg/mL

This price difference reflects more complex manufacturing and lower stability requiring careful handling

Crucially, parietal cells in the stomach lining produce a protein called intrinsic factor , which binds to B12 and enables its absorption in the terminal ileum

In these clinical cases, injections may be given three times a week for several weeks until symptoms begin to subside