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While oral B12 supplements are available, vitamin B12 injections have advantages including enhanced absorption since it bypasses digestion, a fast-acting energy boost from quick absorption, higher blood levels reached versus pills, lasting benefits between maintenance doses, improved concentration and mental clarity, and often more affordable and convenient long-term

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Therefore, the homocysteine level may not rise enough to the abnormal range in a person with Down syndrome with a decrease in vitamin B12 or folate activity