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The body needs more time to restore B12 stores before showing any improvement when starting from a very low initial B12 level

This outcome is more common with severe structural issues, very long-standing chronic pain, or conditions better addressed by other interventions

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cup of beer = 1.4 drinks One 40 oz

While a causal relationship has not been established, patients with depression or other psychiatric conditions should be monitored for changes in mood or behavior, particularly during the initial weeks of treatment or following dose adjustments