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Degree of hyperglycemia and adiposity are important factors

[6] Patients with a history of severe allergic reactions to similar injectable vitamins should not receive this product, or should undergo desensitization under close medical supervision if the therapy is deemed essential

Testing for intrinsic factor antibodies or trying high-dose sublingual B12 for 8 weeks can quickly tell you if shots are your only option

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Also, patients should be warned about the danger of taking folic acid in place of vitamin B12, because the former may prevent anemia but allow progression of subacute combined degeneration