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Identifying genuine deficiency is key, and diagnosis should be confirmed through blood tests arranged by a GP
[13] Chloramphenicol has been shown to blunt reticulocyte response to cyanocobalamin, while ethanol, colchicine, and nitrous oxide interfere with cobalamin metabolism or utilization, each warranting clinician awareness when evaluating suboptimal treatment outcomes
In the UK this is usually a 1mg injection every two to three months though many doctors prescribe more frequent injections
As of writing, studies in laboratory animals have not identified significant safety concerns [3, 4]
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