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It is thought that over time, the disease shifts from an early hypermetabolic state to a hypometabolic state with decreased metabolites (251) and reduced energy production (59), correlating with patient clinical profiles (185)

Without adequate B12, a person would become fatigued, become enervated, and undergo mood changes

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Injection volumes stay small (0.05-0.1 mL), which community sources describe as more comfortable for subcutaneous delivery

Some users take the product ongoing for maintenance

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