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Protein and micronutrient adequacy should also be assessed

M.VithayathilM.CarterP.KarS.ZhengJ.-S.et al (2022)

For those with malabsorption or neurological involvement, UK guidelines recommend hydroxocobalamin injections following specific loading and maintenance schedules

The blame almost certainly lies with other hormonally active agents used concurrently or, just as critically, with contaminated, low-purity products from untrustworthy suppliers