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[26] A complication of severe chronic PA is subacute combined degeneration of spinal cord, which leads to distal sensory loss (posterior column), absent ankle reflex, increased knee reflex response, and extensor plantar reflex response
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The compound is not scheduled under the Controlled Substances Act and is not explicitly banned but it also lacks FDA approval and has no place on the 503A Bulk Drug Substances List, which is the only pathway for licensed compounding pharmacies to legally dispense it
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