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Regular monitoring of INR should be performed on all treated patients

As more and more high dose oral B12 is administered the situation gradually gets worse and worse, because now much of the HC secreted in saliva (Collins etal 1999) already has inactive B12 bound to it, and so this HC-B12 complex can no longer protect incoming B12 from acid hydrolysis

Hence, the authors are concluding that it's worth it to conduct trials in humans (Valizadeh et al., 2021)

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Understanding these nuances is the first step toward designing a rigorous and effective study