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These patients may experience a blunted or impeded response to the intranasal medication

doi: 10.1038/nprot.2006.378 [DOI] [PubMed] [Google Scholar] 34.Muscat JE, Kleinman W, Colosimo S, Muir A, Lazarus P, Park J et al

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The body can do this but many times the reason the deficiency exists is because there is some venerability with formation of methyldonors (like methylcobalmin)

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This reaction eventually leads to the formation of lipid peroxide breakdown products