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Vit B12 replacement therapy, typically administered intramuscularly, is the cornerstone of treatment (Marotta and Kesserwani, 2020)
Patients should be informed of the pros and cons of oral versus parenteral therapy, and regardless of the form of treatment, those with pernicious anemia or malabsorption should be reminded of the need for lifelong replacement
JIMD Rep 13:2731
Many patients report early improvements in gut comfort and reduced skin irritation within the first one to two weeks
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