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A total of 445 articles were evaluated using their full texts, while 358 articles were removed due to factors such as untrustworthy study designs (including case reports, ethnographies, and observational designs), patient populations, interventions, outcome measurements, sample sizes smaller than 10, or the inaccessibility of the full text

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Safety Protocols and Sterility Self-administration requires a commitment to sterile technique to avoid infections or injection site reactions

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In the Krebs cycle, adenosylcobalamin can induce the accumulation of succinate, an antagonist of histone and DNA demethylation reactions catalyzed by enzymes of the 2-oxoglutarate-dependent dioxygenase family, which may favor the activation or inhibition of gene expression ( Figure 5 )