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It insulates the nerve cells and improves the efficiency of electrical signal transmission [27, 28]
It will get worse over time if not treated
Similarly, although hepatic dysfunction can occur with large niacin doses (1-3 grams daily over months) causing elevated liver enzymes or jaundice, niacinamide at 100 mg is very unlikely to have any adverse effect on the liver
In some centres, holotranscobalamin (active B12) may be available as an alternative test
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