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Each type targets specific health needs, and some individuals mix regimens to maximize wellness

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Hydroxocobalamin injections are the UK first-line treatment, administered intramuscularly to ensure reliable B12 delivery independent of gut absorption

Ligand binding activates adenylyl cyclase, elevating intracellular cAMP and triggering PKA-mediated phosphorylation of downstream steroidogenic targets including CYP11A1, CYP17A1, and 3-HSD