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Increased Energy Levels: Vitamin B12 is crucial for energy production

Conversely, patients with minimal adverse effects and inadequate therapeutic response may undergo more rapid titration under careful medical supervision

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Intrinsic (mitochondrial) pathways are also activated, with pro-apoptotic Bcl-2 family members (Bid, Bak, Bax) promoting mitochondrial outer membrane permeabilization, cytochrome C release, and apoptosome formation (cytochrome C + APAF-1 + procaspase-9)

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