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PMC 2702487

Its well-studied, stable at refrigerated temperatures, and effectively inhibits the growth of most common bacteria that could be introduced into a multi-use vial

In fact, the region is home to more than 2,000 species, from scaleless, oily fishes called golomyanka to unique freshwater seals called nerpa , most of which can be found nowhere but Lake Baikal

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Conditions include alcoholic liver disease, viral hepatitis, cirrhosis, and primary or metastatic liver cancer Renal dysfunction : Impaired kidney function reduces B12 elimination, causing accumulation even with normal intake Haematological conditions : Myeloproliferative neoplasms, chronic myeloid leukaemia, polycythaemia vera, and hypereosinophilic syndrome increase transcobalamin production, elevating total serum B12 Laboratory interference : Macro-B12 (immunoglobulin-bound B12) and assay interference can cause spuriously elevated results without true excess In clinical practice, unexplained hypercobalaminaemia should prompt investigation for underlying disease, particularly in patients without obvious supplementation history