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Others experience it as a loss of pleasure or mild emotional flatness around food. Trial mood scores moved slightly better rather than worse, so the negative experience appears to be a minority signal that standard adverse-event tables do not capture well

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The authors suggest that either methyl-B12 and adenosyl-B12 should be given together, or either cyano-B12 or hydroxo-B12 on their own, both of which can be converted into both active forms