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Proper contaminant screening should cover at minimum heavy metals, microbial counts, endotoxins, and residual solvents

Causes of vitamin B12 deficiency Pernicious anaemia Pernicious anaemia is the most common cause of vitamin B12 deficiency in the UK

Dysesthesia An abnormal skin sensation

The report was uncontrolled, unblinded, not randomized, had no comparator arm, used patient-reported outcomes rather than validated pain instruments, and did not publish dose, effect size, confidence intervals, p-values, or systematically collected adverse events limitations that severely constrain any clinical inference