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In the presence of neurological symptoms, following daily treatment, injections up to weekly or biweekly are indicated for six months before initiating monthly IM injections

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Measurement of serum methylmalonic acid should be used to confirm deficiency in asymptomatic high-risk patients with low-normal levels of vitamin B 12

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Experimental approaches in this area often include second messenger analysis, such as cyclic AMP quantification, as well as kinase activation profiling and transcriptional response studies