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Within body tissues, the specific B12 binding proteins transcobalamin I and II facilitate the absorption of cyanocobalamin into the cells.1017 Cyanocobalamin is a cofactor for the synthesis of two major enzymes in the body namely methionine synthase and L-methymalonyl-CoA mutase

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In the steady state, RBC production is in equilibrium with RBC removal from circulation, which can be accomplished by two different mechanisms: hemolysis and phagocytosis by macrophages