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In several European countries, this is an official indication for treatment

It is a 16-amino acid peptide that activates AMPK, the master metabolic regulator, by inhibiting the folate cycle and accumulating AICAR, a potent endogenous AMPK activator

Certain congenital conditions, such as hereditary intrinsic factor defects and congenital vitamin B12 malabsorption (Imerslund-Grsbeck disease), can also cause severe vitamin B12 deficiency