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In liver diseases such as hepatitis, fatty liver disease, or cirrhosis, stored B12 and B12binding proteins may be released into the bloodstream, contributing to elevated levels

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1 Hydroxocobalamin can also act as a scavenger of peroxynitrites that may build up in the body (particularly for those who may have COMT & other such mutations), converting the reactive oxidant back into methionine

A researcher cannot distinguish between them without analytical chemistry equipment