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Green et al 26 Severe clinical abnormalities should be treated intensively with B 12 , cyanoB 12 or hydroxyB 12 : HydroxyB 12 is commonly used in Europe, often at intervals of 23 months, as it seems to have better retention than cyanoB 12
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This was because hydroxocobalamin produced by bacteria was changed to cyanocobalamin during purification in activated charcoal columns after separation from the bacterial cultures (because cyanide is naturally present in activated charcoal)
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