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In general, there is a lack of reports testing PAP toxicity in HK-2 cells because the studies evaluating the toxic effect of PAP in kidney cells were usually performed in porcine LLC-PK1 cells (Foreman and Tarloff 2008

For injectable research use, timing discussions are speculative because there is no approved protocol or strong human evidence to anchor them

Low-normal or borderline B12 levels combined with elevated MMA may indicate functional B12 deficiency even before overt symptoms appear