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Plasma exhibited the highest concentrations of fatty acids (stearic acid, EPA, and arachidonic acid), while TCA cycle intermediates (succinic acid, citric acid, and malic acid) were most concentrated in the urine

If your pen dose counter displays numbers higher than these (some counterfeits have been found with dose counters going up to 80), the product is fake

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If you have sub-optimal levels with symptoms, its worth a trial of B12 even if your serum B12 levels are normal