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In humans the predominant sialic acids are N-acetylneuraminic acid (Figure 5) and its hydroxylated derivative, Neu5Gc, the latter of which is solely derived from dietary sources (253)

Many practitioners recommend supplementing with oral methylcobalamin or sublingual B12 in addition to the compound, particularly for patients who have been on therapy for more than six months or who have documented low B12 levels

Ahmadi, and D.J

How do vitamin B12 injections help restore energy and reduce fatigue

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