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its usually short-lived and manageable
However, serum B12 has a limitation: it can appear within the reference range even when cellular-level deficiency exists, because it captures both active and inactive forms of the vitamin
Some may notice gradual improvements in energy, focus, and metabolism over a few days to weeks with consistent use
Cautious use of parenteral cyanocobalamin is also recommended in patients with renal impairment, including premature neonates, because of the possibility of greater aluminum accumulation, which may cause central nervous system and bone toxicity
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