One group includes patients who have chronic HBV infection and HCC in the absence of cirrhosis, presumably because of the oncogenic effects of HBV proteins and HBV integration, inherited familial tendency, and, in certain areas of the world, the synergistic effect of exposure to dietary aflatoxin
Gwyer D, et al
The elderly (reduced absorption) Pernicious anemia Vegetarians / Vegans (low dietary B12) People taking metformin or acid reflux medications (PPIs) Post-bariatric or gastric-bypass patients Genetic variants in MTRR , MTR , or TCN2 What Has B12 Been Studied For
Signs of poor conversion or B12 deficiency include: Chronic fatigue Brain fog and poor focus Mood imbalances, anxiety, or depression Numbness or tingling in extremities Elevated homocysteine Poor detoxification For these individuals, Methyl B12 supplementation isnt just helpful its essential
Administration technique errors Spraying too rapidly without allowing absorption time leads to solution dripping down the throat and being swallowed rather than absorbed