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In the shuttle, glutamate is converted to glutamine in astrocytes, and then exported to neuronal system A transporters, where it is converted to glutamate intracellularly by phosphate activated glutaminase (21)

Temperature excursions above 8C cause irreversible protein denaturation even a single overnight period at room temperature can reduce potency by 3060%

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Furthermore, Premier has recently added the Zimmer Cryo 6 to our practice

This distinction affects storage requirements

While the normal range is typically between 138-652pmol/L, the reality is that many patients feel better if B12 levels are in the higher end of that range