> Subligual methylcobalamin works just as well as the shots
It does not. The cobalamin molecules are quite large and don’t penetrate the sublingual mucosa very well. On top of that, the proteins in saliva that bind to B12s will cause any bound B12 to not absorb sublingually, instead having to wait to make it through the digestive system for intestinal uptake.
Sublingual is still certainly a better option than oral pills, but the injections are preferable in severe cases for a reason.
> Apparently this form of B9 absorbs better if it’s combined with the methylated form of B12 (methylcobalamin)
B9 and B12 are interdependent. When the body uptakes cobalamins, the ligands are pulled off and replaced with ligands sourced from other processes. IIRC in the case of methylcobalamin, the methyl group is pulled off and replaced with a methyl group that’s moved over from methylfolate via a riboflavin-dependent reaction. Been a hot minute since I looked into this so I may have some details incorrect.
> The paradoxical B12 deficiency might have a relation with the inactive form being supplemented.
Yup, not everyone can convert cyanocobalamin or hydroxocobalamin to adenosyl-/methylcobalamin. Especially in severe cases, anecdotally I’ve seen people not make progress with the standard cyanocobalamin injections, but then make huge progress with methylcobalamin injections. Unfortunately, methylcobalamin is often not preferred in injectable form due to very quick degradation into hydroxocobalamin upon exposure to light.
It may help, but it will also throw off lab tests while you’re taking it and for a time after. Also, B12 absorption depends strongly on good gut health (ex. no SIBO[1], low gastric acid, pernicious anaemia, etc.), as well as on other medications (ex. metformin[2]) not interfering with absorption.
> Vitamin B12 deficiency can cause PGH through unknown mechanism. About 55% of patients with pernicious anemia had graying before 50 years as compared to 30% in the control group.[32]
/soapbox
Get your B12 tested (before taking supplements!).
B12 deficiency is known to present in many ways, and also to be often overlooked in clinical settings[1]. It’s known that not everyone presents with the anaemia from it[2], which is often why it’s skipped as a diagnostic option. Additionally, long-term/severe deficiency can present with symptoms almost identical to multiple sclerosis[3]. Deficiency of other B vitamins, such as B2, can cause a functional B12 deficiency as well[4]. It’s also known that supplementation will falsely elevate levels even in the presence of a deficiency.
Fingers crossed UT2004 will end up in the Archive eventually. I still boot it up to play occasionally because nothing else has scratched the arena shooter itch that well.
> The maintenance burden for a VPS: periodically run apt update upgrade. Use filesystem snapshots to create periodic backups. If something happens to your provider, spin up a new VM elsewhere with your last snapshot.
And make sure it reboots for kernel upgrades (or set up live-patching), and make sure that service updates don't go wrong[0], and make sure that your backups work consistently, and make sure that you're able to vertically or horizontally scale, and make sure it's all automated and repeatable, and make sure the automation is following best-practices, and make sure you're not accidentally configuring any services to be vulnerable[1], and ...
Making this stuff be someone else's problem by using managed services is a lot easier, especially with a smaller team, because then you can focus on what you're building and not making sure your SPOF VPS is still running correctly.
[0] I self-host some stuff for a side-project right now, and packages updates are miserable because they're not simply `apt-get update && apt-get upgrade`. Instead, the documented upgrade process for some services is more/less "dump the entire DB, stop the service, rm -rf the old DB, upgrade the service package, start the service, load the dump in, hope it works."
[1] Because it's so easy to configure something to be vulnerable because it makes it easier, even if the vulnerability was unintentional.
Probably, but Clickhouse has been zero-maintenance for me + my dataset is growing at 100~200GB/month. Having the Clickhouse automatic compression makes me worry a lot less about disk space.
> Mitochondria have been demonstrated to utilize quantum tunneling in their function as the powerhouse of eukaryotic cells.