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Either way, it is often caused by a deficiency in vitamin B12

A systematic review of 35 prospective cohort studies assessing the association between vitamin B 12 status and cognitive deterioration in older individuals with or without dementia at baseline did not support a relationship between serum vitamin B 12 concentrations and cognitive decline, dementia, or Alzheimers disease (79)

MHA is currently included as a constituent of some dietary supplements sold today, including via the Internet

[1] [2] However, many products allow limited room-temperature storage periods according to their FDA-approved prescribing information