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