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Patient selection criteria are not well-established, and determining which patients are most likely to benefit from these therapies requires clinical judgment based on limited evidence

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[16] Although cyanocobalamin lacks a defined upper-toxicity threshold due to its water solubility and renal elimination, exceptionally high cumulative doses have been temporally associated with acneiform eruptions, altered potassium homeostasis, and theoretical thrombotic risk, emphasizing the importance of evidence-based dosing

Can I use tirzepatide with B12 if I have the MTHFR gene mutation