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Epoetin alfa is a 165 amino acid glycoprotein manufactured by recombinant DNA technology, and has the same biological effects as endogenous erythropoietin Erythropoietin (Epo) stimulates red blood cell proliferation and differentiation by interacting with erythropoietin receptors on red cell progenitors

Anubhav Singh Introduction: How Does Methylcobalamin Differ from Cyanocobalamin

So it's worth asking if their intake of B12 could be an influence

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