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Whether someone with PA can utilize liver stores is something I'm not sure about - some textbooks indicate that the mobilization mechanism of B12 from the liver is not well understood

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The honest total cost comparison A telehealth protocol that appears to cost $150 per month may actually cost $150 for the vial, $100 to $300 for the labs you need before starting, $30 to $80 for supplies per month, and an unknown variable for how long you need to run it without clear feedback on whether it is working