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Anaphylactic shock and death have been reported with administration of parenteral vitamin B12 (see WARNINGS)

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The G6PD gene encodes for glucose-6-phosphate dehydrogenase enzyme

One potential mechanism is the Nrf2-ARE pathway, which induces a phase 2 detoxification response that promotes disruption of Nrf2-Keap protein interactions, translocation of Nrf2 to the nucleus, and regulation of target gene expression through the ARE, enhancing cellular defense against oxidative damage (Hu et al., 2004

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