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Furthermore, most studies prioritize symptom improvement (e.g., pain reduction) as endpoints, with a pronounced lack of robust evidence demonstrating structural modification (e.g., cartilage preservation via quantitative MRI)

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A couple of studies found no benefits of B12 for lowering homocysteine in HD patients, one used oral B12, 2000 g three times per week for 6 weeks, 55 the other used methyl-B12 i.m

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