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High-dose supplementation, particularly hydroxocobalamin injections, has been associated with acne-like eruptions and rosacea flare-ups in susceptible individuals

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Due to this, different routes for the administration of supplements may be necessary, such as: Oral replacement therapy is recommended to patients with asymptomatic, moderate illness who have no concerns about absorption or compliance

The net potential of these molecular events is posited to be an environment more favorable to cell survival, in which proliferative signals outweigh apoptotic triggers

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