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The upregulation of the protein known as actin keeps the structural integrity of cells intact and allows them to function properly [14]
In a case series study from New York of people with overt neurological symptoms from B12 malabsorption, MMA levels ranged from 755 to 187,000 nmol/l (Lindenbaum, 1988)
A single overnight at 68 to 74 degrees Fahrenheit is unlikely to cause significant degradation, but the lack of standardized stability data means you should verify with your specific pharmacy
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Conditions that can cause cobalamin deficiency include: Inflammatory bowel disease (IBD) Exocrine pancreatic insufficiency (EPI) Pancreatic cancer Chronic enteropathy Alimentary lymphoma Small intestinal dysbiosis Inherited selective cobalamin malabsorption Inherited selective cobalamin malabsorption, which is known as Imerslund-Grsbeck syndrome (IGS) in humans, makes a dog genetically predisposed to have difficulty absorbing cobalamin
