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However, some genes may fail to undergo silencing and thus escape inactivation, producing biallelic expression of gene product (24)

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Symptoms may include: Shortness of breath Red, flushed skin Headaches Rapid weight gain, polycythemia (increased red cell mass), hypokalemia, CHF, pulmonary edema, and vascular thrombosis are mostly observed in therapeutic contexts where vitamin B12 is administered aggressively or over extended periods

Some individuals progress through standard dosing, while others may need adjustments for faster results, fewer side effects, or better long-term maintenance

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