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High dose oral cobalamin would be a reasonable alternative as maintenance in patients unable to tolerate intramuscular injections provided there is good compliance with treatment
But the companies making and promoting these peptides are not especially deserving of blind trust
Moisten a cotton ball with rubbing alcohol and use it to wipe the skin at the injection site
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Treatment should not be delayed if neurological symptoms occur, as nerve damage may become irreversible without prompt B12 replacement
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