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methylcobalamin vitamin b12 cofactor water-soluble metabolism mecbl meb12 cobalamin dna synthesis circulatory system nervous myelin bone marrow methyl group octahedral cobalt metal–alkyl bonds gastric intrinsic factor arteria arteries artery atherosclerosis blocked stroke cardiac arrest heart attack blood cell thinner cardiology circulation muscle flow flowing triglyceride micrograph obesity occlusion plaque pressure red sedentary vascular vein vessel levels