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Commonly used for weight loss, energy, pernicious anemia, schilling test and overall health
Providers generally initiate one agent first, assess tolerance, then add the second at low dose with regular follow-ups
However, following a gradual dose escalation schedule, maintaining adequate B vitamin and mineral intake, optimizing sleep quality, managing stress, and monitoring for early sensory changes during dose increases may help reduce risk or enable early detection
Severe impairment: Confusion, disorientation, difficulty standing, nausea, increased risk of asphyxiation on vomit, and reduced pain sensitivity
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