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This decline is not cosmetic

After the B12 receptors are saturated, the excess methyl-B12 not bound to receptors will be filtered from the blood by the kidneys and excreted into the urine within 30-45 minutes after the injection

After treatment with -ketoglutarate (-KG), mitophagy flux increased, mitochondrial structure and function significantly improved, ROS production was inhibited, and OA was improved through the alleviation of chondrocyte apoptosis [268]