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The Framingham Heart Study found that elevated B12 at baseline was associated with two markers of impaired kidney function, but, upon follow-up, a previously elevated B12 was not associated with a future diagnosis of either condition — meaning poor kidney function most likely caused the elevated B12, not vice versa (McMahon, 2015)
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Because its mechanism of action is isolated to cellular enzyme inhibition, it carries a very low risk of negative interactions with central nervous system stimulants or gut hormones
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