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However, the administered NA dose was based on efficiency in hypercholesterolemia studies, therefore, an optimal NA dose for mitochondrial myopathy has to be determined, especially considering that another study found an association between metabolites of excess NA, 2PY, and 4PY, and cardiovascular disease (CVD) 245

However, comparative studies between different pharmaceutical forms (cyanocobalamin versus hydroxocobalamin) are limited

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Others find once-daily dosing effective, as the peptides tissue-level effects persist beyond its measurable blood concentration