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Because adequate, well-controlled studies in pregnant individuals are lacking, use should be limited to circumstances in which the potential maternal benefit clearly outweighs theoretical fetal risk-such as treatment of documented systemic carnitine deficiency
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The AAFPs evidence-based clinical review states directly: Oral administration of high-dose vitamin B12 (1 to 2 mg daily) is as effective as intramuscular administration for correcting anemia and neurologic symptoms in patients with B12 deficiency (Langan RC, Goodbred AJ, American Family Physician, 2017)
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