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If the vitamin is administered by injection in response to a deficiency and enters the bloodstream directly in high concentrations, an immunologic reaction with skin reactions is possible

For instance, a patient with borderline low B-vitamin levels might receive 0.5 mL IM weekly, whereas someone with severe malabsorption could receive 1-2 mL IM two to three times per week initially

The ultimate goal is to generate clinical evidence that leads to official changes in treatment guidelines, ensuring that injection frequency is based on patient-reported symptoms and individual clinical response, rather than solely on national blanket protocols