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Heres what the BSH Guidelines for Cobalamin (B12) and Folate Disorders say:

Ceramosides is a clinically studied, plant-based source of phytoceramides used to support skin hydration and elasticity

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Studies have suggested that AOD9604 is more effective than its predecessor AOD9401

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They may need to rely on supplements or vitamin B12 injections to maintain adequate levels, and the frequency of supplementation will affect how long the vitamin stays in the body