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These side effects often result from increased cell growth, tissue expansion, and shifts in metabolic processes, which are more pronounced with higher doses or prolonged use

Conclusions Ultimately, the current maintenance dose of 1,000 mcg B12 every 3 months may confer long term harm, therefore it seems that once B12 levels are stabilised well within acceptable range, then the standard B12 intervention of 1000 mcg should be administered annually, and monitored with pre-injection annual testing of levels

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