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Exceeding these doses is not recommended, as safety and efficacy data beyond these levels are limited

Always refrigerate when not actively using

Dysregulated, constantly sympathetic dominant state

Prompt recognition of this rare presentation can prevent the misdiagnosis of TTP and the associated use of high steroids and plasmapheresis, preventing potential adverse effects and high cost (12)

B12 injections are often necessary for individuals presenting with many of the symptoms mentioned and risk factors such as high alcohol intake, pernicious anemia, hereditary conditions, AIDS, and many digestive diseases

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