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Mechanistically it adds steric and electrostatic bulk at the same end of the molecule the binding proteins engage, deepening the reduction in affinity beyond what the single substitution achieves alone
That means the body can more easily use this form of B12, making it more effective
loading (20g/day in 4 divided doses for 5 to 7 days) saturates stores faster but is optional
Similar trends were observed in a mouse model of pancreatic ductal adenocarcinoma (PDAC) ( LSL-Kras G12D/+ Trp53 f/f Pdx1 cre (KP / C) mice 28 ) and in humans with renal cell carcinoma 29 (Extended Data Fig
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