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[7] [4] Neurological symptoms can occur even before anaemia develops and include paraesthesia (pins and needles) in the hands and feet, numbness, difficulty walking, and balance problems due to subacute combined degeneration of the spinal cord

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It means that a significant portion of the orally administered 5-Amino-1MQ might not actually reach systemic circulation in its active form, or at least not at the desired concentration

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