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doi:10.1016/j.kint.2023.10.016 8

For example, in a postmenopausal woman with low estrogen - if the 2OH/4OH ratio is low (indicating a preference for the more damaging 4-OH pathway), however, the 4-OH value is at the low end of the postmenopausal range, then the low ratio may not be as concerning

This is because its a naturally occurring peptide produced in the body

I had x6 b12 injections in 2 weeks 3 months ago

Saigusa, D., Okamura, Y., Motoike, I

As the deficiency may be indistinguishable for either of these essential vitamins they are often grouped in one product for therapeutic and preventive use